The word "executive" usually makes people think of expensive suits, private jets, and million-dollar bonuses to be enjoyed on tropical islands. If you become an HMO (health management organization) executive, all those things could be yours—but not without a cost.

And we're not talking about a cost you pay in cash. It'll cost you your sleep, your health, your social life, your family time, your vacations, and maybe even your reputation as a stand-up kind of person.

HMO execs usually aren't beloved by the public because it sort of doesn't seem fair that the head of an HMO—a type of health insurance company geared towards providing affordable health insurance to lower-income patients—can make millions while occasionally providing less-than-great coverage to people.

You will make millions, by the way. If you make it to an executive position, that's a guarantee. The upside of this high-stress job is it comes with a killer paycheck. The average salary for an HMO executive is somewhere in the $150,000 to $250,000 range (source)—and that doesn't even take into account the buckets of extra cash HMO executives make from bonuses, stock options, and other incentives given to them by investors and their boards of directors (source). 

 

This could be your home away from home. (Source)

To give you some perspective, the CEO of Humana Healthcare made about three million dollars in 2012 alone (source). Hello, private jet, vacation home in the Bahamas, and thousand-dollar meals. Like we said, the killer paycheck makes a lot of things better.

That all sounds pretty good, right? Well don't get too excited. It's not all fun—in fact, most of it isn't. HMOs aren't charities, they're businesses; being an HMO exec isn't about making sure that everyone, regardless of income, gets quality healthcare. It's about bringing in that money. That means more than one sleepless night, high-stress work day, and heated argument about some pretty controversial topics. This career is not for the faint of heart.

In order to provide affordable health insurance to lots of people, an HMO has its members choose a physician from a list of approved health care providers. Members of HMOs are usually only allowed to see specialists (like cardiologists or neurologists) based on the approval of their physician or primary care provider.

See, the primary care provider has to follow a bunch of criteria given by the HMO in order to decide whether or not a patient can see a specialist. HMOs don't want people going to see neurologists all willy-nilly—that's more expensive for them. By dictating which medical facilities patients can go to and when they're able to see a specialist, HMOs are able to save a lot of money, and therefore cost much less for members...which also means a tidy profit for the HMO.

Now, the term "executive" is kind of vague. At an HMO, "executive" could mean anything from Vice President for Managed Care, to Senior Vice President for Marketing and Sales, to CEO or COO. Other executives might be in charge of regional clinical services or managing contracts and negotiations. There are lots of avenues that you can look at if you're interested in becoming an executive; the important thing is playing to your strengths.

 

Yeah, he looks good, but he hasn't slept in weeks. (Source)

No matter which executive position you're lucky enough to land, the job is going to be tough. As a CEO, you're a head officer of the insurance organization and responsible for maintaining the vision—and more importantly the money—of your organization. You're making sure that whatever the investors and the board of directors want, they get. Because if they're not getting it now, they'll get it soon, even if that means you're not part of the team anymore.

As we're sure you know, the business of making money is no walk in the park. HMO executives are expected to work over seventy hours a week in an extraordinarily high-stress environment. If you're planning on becoming an HMO executive, plan on missing a lot of your kid's ballet recitals.

It's not just the job that's stressful; getting in is pretty difficult too. There are tons of managed care managers fighting for a very small number of executive positions—positions which aren't likely to be vacated anytime soon.

There's not really a path that will guarantee your spot in the big leagues, either. Often, it just comes down to getting lucky. And once you get in, you'll always be painfully aware of the fact that there are a lot of competent, ambitious people who'd do just about anything to get your job. One slip-up, and you could be done for.

If you want to become an HMO executive, get ready for late nights and lots of stress. The job can be rewarding in that you're providing affordable healthcare to the public, but at the same time, the bottom line is always about making money. This ain't a charity, y'all.

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