Updated
PERM occupation, SOC 11-9111.00, #206 of 1,410 by filings
Medical and Health Services Managers
- Biggest sponsor
- HENRY FORD HEALTH SYSTEM · 2% of its filings
- Busiest state
- CA · 23% of its filings
- Major group
- Management · SOC 11
Weighing an offer for this job?
Where it falls among certified offers, and the four wage levels DOL sets for it by area.
Median wage
$104,572
all PERM $103,272
Filings
209
#206 of 1,410
Approval
92.4%
field 96.8%
Median days
483
6 slower than the field
What it pays
Where its median offer sits among every occupation, then the whole ladder of certified offers by year and by state.
Median offered wage
$104,572above 71%
Approval rate
92.4%ahead of 23%
Median days to decision
483 daysahead of 29%
Each bar counts occupations at that value. More
- 5th to 95th
- 25th to 75th
- Median
- 10th and 90th
FY2025
$106,205 median · 105 certified cases
FY2026
$107,000 median · 71 certified cases
- 10th
- $71,032
- -5.7% since FY2025
- Median
- $107,000
- +0.7% since FY2025
- 90th
- $178,922
- +3.3% since FY2025
- 95th
- $216,216
- +8.6% since FY2025
Each row is that fiscal year's certified filings, counted on their own. A percentile is over the year, so a year with far fewer cases behind it is a thinner measurement than one with more.
| Fiscal year | Cases | 5th | 10th | 25th | Median | 75th | 90th | 95th |
|---|---|---|---|---|---|---|---|---|
| FY2025 | 105 | $65,666 | $75,317 | $90,000 | $106,205 | $135,720 | $173,240 | $199,166 |
| FY2026 | 71 | $67,038 | $71,032 | $81,816 | $107,000 | $160,827 | $178,922 | $216,216 |
A median answers whether pay moved. More
Who files it
The sponsors and firms with the most PERM filings under this code, the places the work sits, and who the workers were.
Sponsors filing it
- HENRY FORD HEALTH SYSTEM 5 filings
- ATI Holdings LLC 4 filings
- Boston Medical Center Corporation 3 filings
- BELLE FOUNTAIN REHABILITATION & NURSING CENTER, INC. 2 filings
- Beth Israel Medical Center 2 filings
- Cole Speech & Language Center, LP 2 filings
How this is counted
The employers with the most applications under this code. 18 of 209 filings, 9% of the total.
Firms filing it
- Fragomen Del Rey Bernsen & Loewy LLP 9 filings
- Danielian, LeCroy & Kolanjian 6 filings
- ELLIS PORTER PLC 6 filings
- Jackson Lewis P.C. 6 filings
- Greenberg Traurig LLP 4 filings
- Berry Appleman & Leiden LLP 3 filings
How this is counted
The law firms named on the most applications under this code. 34 of 209 filings, 16% of the total.
Where the jobs are
- California 48
- New York 26
- Texas 18
- Michigan 17
- Massachusetts 13
- Pennsylvania 10
How this is counted
The worksite state on the application, which is where the job is and not where the company is headquartered. Volume by state across everyone is on the state map. These 6 states cover 132 of 209 filings.
Where the work is
- Brooklyn, NY 10
- Houston, TX 8
- Detroit, MI 6
- Los Angeles, CA 6
- New York, NY 6
- Cambridge, MA 4
How this is counted
The worksite city on the application, which is where the job is. These 6 cities cover 40 of 209 filings.
- Every sponsor that files it, by state, approval rate, offered wage and time to a decision
- Every filing for it, PERM, wage requests and H-1B, case by case
Newspapers it advertised in
- 13 cases
Los Angeles Times
- 12 cases
The New York Times
- 10 cases
Los Angeles Daily News
- 9 cases
The Washington Post
- 7 cases
The Boston Globe
- 7 cases
Houston Chronicle
How this is counted
The newspaper or professional journal named for each case's two print ads, one count per paper per case, however the filer spelled it.
Additional steps it used
- 185 cases
Job search websites
- 152 cases
Local or ethnic newspapers
- 85 cases
The employer's website
- 71 cases
Radio or TV ads
- 43 cases
Employee referral programs
- 19 cases
Trade or professional organizations
How this is counted
The steps a professional job needs beyond the job order and the ads, by the number of cases that name each.
How long before filing it began
- 0.0%
Under 30 days
- 0.5%
30 to 59 days
- 30%
60 to 89 days
- 25%
90 to 119 days
- 17%
120 to 149 days
- 26%
150 to 180 days
- 2.5%
Over 180 days
How this is counted
Days from the first recruitment step to the filing. 20 C.F.R. § 656.17(e) puts the job order and ads 30 to 180 days before filing.
The job itself
What O*NET says the work is, what the market pays it by BLS's survey, its outlook, and DOL's wage levels year by year.
- United States597,080 jobs
- New York-Newark-Jersey City, NY-NJBrooklyn, New York
- Houston-Pasadena-The Woodlands, TXHouston
- Detroit-Warren-Dearborn, MIDetroit
- Los Angeles-Long Beach-Anaheim, CALos Angeles
- Boston-Cambridge-Newton, MA-NHCambridge
- middle half of pay (BLS)
- median
- 10th to 90th percentile
- DOL's Levels I to IV, left to right
- median PERM offer
| Area | BLS median | Level I | Level II | Level III | Level IV |
|---|---|---|---|---|---|
| United States | $123,860 | ||||
| New York-Newark-Jersey City, NY-NJ | $167,580 | $111,051 | $151,902 | $192,774 | $233,626 |
| Houston-Pasadena-The Woodlands, TX | $124,400 | $80,184 | $107,120 | $134,077 | $161,013 |
| Detroit-Warren-Dearborn, MI | $114,340 | $76,336 | $105,040 | $133,723 | $162,427 |
| Los Angeles-Long Beach-Anaheim, CA | $134,230 | $77,085 | $113,277 | $149,490 | $185,682 |
| Boston-Cambridge-Newton, MA-NH | $136,760 | $97,802 | $131,872 | $165,963 | $200,034 |
How these figures fit together
BLS surveys employers on what they pay everyone in a job; DOL builds its four levels from the same survey a year later (the July 2026 wage year uses BLS's May 2025 estimates). DOL publishes levels by area, not nationally, so the United States line has none. Levels are hourly in DOL's tables; here they're shown a year at 2,080 hours, as DOL computes them. The metros are the ones holding the most of this job's PERM filings, placed by Census's county files.
The block is the middle half of what employers report paying everyone in this job, citizen or not; the ticks under it are DOL's four prevailing wage levels for that metro, the floors a PERM or H-1B offer is held to. More
DOL's levels for this job in New York-Newark-Jersey City, NY-NJ, year by year
Each July DOL resets the four levels from BLS's newest survey. A determination keeps the figures of the year it was issued in.
| Wage year | Level I | Level II | Level III | Level IV |
|---|---|---|---|---|
| 2026-27 | $111,051 | $151,902 | $192,774 | $233,626 |
| 2025-26 | $103,293 | $143,250 | $183,186 | $223,142 |
| 2024-25 | $99,486 | $139,214 | $178,922 | $218,650 |
| 2023-24 | $97,531 | $134,742 | $171,954 | $209,165 |
| 2022-23 | $99,195 | $127,650 | $156,083 | $184,538 |
| 2021-22 | $94,120 | $123,864 | $153,587 | $183,331 |
What the job is
Plan, direct, or coordinate medical and health services in hospitals, clinics, managed care organizations, public health agencies, or similar organizations.
- Preparation
- Considerable Preparation Needed
- O*NET Job Zone 4
- DOL's education basis
- Bachelor's degree
- Wage year 2026-27, on DOL's Appendix A list
- Jobs, 2025 to 2035
- +24.2%
- About 62,300 openings a year (BLS)
- Typical entry
- Bachelor's degree
- Less than 5 years of related work (BLS)
Bright Outlook O*NET OnLine lists this job for rapid growth.
The work, most important first
- Direct, supervise and evaluate work activities of medical, nursing, technical, clerical, service, maintenance, and other personnel.
- Develop and maintain computerized record management systems to store and process data, such as personnel activities and information, and to produce reports.
- Plan, implement, and administer programs and services in a health care or medical facility, including personnel administration, training, and coordination of medical, nursing and physical plant staff.
- Conduct and administer fiscal operations, including accounting, planning budgets, authorizing expenditures, establishing rates for services, and coordinating financial reporting.
- Maintain awareness of advances in medicine, computerized diagnostic and treatment equipment, data processing technology, government regulations, health insurance changes, and financing options.
- Establish work schedules and assignments for staff, according to workload, space, and equipment availability.
The education workers in it report
- 7%
Post-Secondary Certificate
- 11%
Associate's Degree or other 2-year degree
- 46%
Bachelor's Degree
- 21%
Master's Degree
Titles people use for it
Clinical Director, Health Information Management Director (HIM Director), Health Information Manager (HIM Manager), Nursing Director, Cancer Center Director, Healthcare System Director, Medical Records Director, Medical Records Manager.
Related jobs: Health Informatics Specialists, Health Education Specialists, Clinical Nurse Specialists, Social and Community Service Managers, Health Specialties Teachers, Postsecondary, Management Analysts.
This section includes information from the O*NET 31.0 Database and O*NET OnLine by the U.S. Department of Labor, Employment and Training Administration (USDOL/ETA), used under the CC BY 4.0 license. O*NET® is a trademark of USDOL/ETA. PERM Tracker has modified some of this information (the shares are rounded and only the top tasks are shown); what changed. USDOL/ETA has not approved, endorsed, or tested these modifications.
Against other jobs
Where this sits in the ranking
Ranked 206 of 1,410 by volume: 205 filed at least as many filings, and 1,204 filed no more.
- Just above
- Airline Pilots, Copilots, and Flight Engineers 210 filings
- Just below
- Cement Masons and Concrete Finishers 209 filings
Other management roles
Occupations sharing this one's SOC major group, which is carried in the first two digits of the code. More
Occupations sharing this one's SOC major group, which is carried in the first two digits of the code. Wages inside a group still swing hard, because the group holds every seniority level and every metro.
- #202 Chief Executives 215 filings · 23 denied
- #212 Treasurers and Controllers 195 filings · 6 denied
- #198 Construction Managers 219 filings · 20 denied
- #197 Sales Manager 219 filings · 13 denied
- #217 Logistics Managers 189 filings · 9 denied
- #218 Industrial Production Managers 189 filings · 4 denied
The same job on H-1B
3,325 certified H-1B labor condition applications for this occupation since FY2020, offering a median of $104,000 a year; the middle half ran $86,000 to $145,000. By state and year in the salary explorer.
Notes on these numbers
Reading the wage
A floor, not a salary survey: every level and metro mixed. DOL's four wage levels for this job, by area.
What the median is
The median wage employers committed to in federal filings for this occupation. It mixes every experience level and every metro, and it's a floor: the employer must offer at least the prevailing wage DOL determines for the occupation, level and county. Across all PERM filings the middle half of offered wages runs $45,178 to $141,357, so a figure inside that band is unremarkable whichever occupation it belongs to. The levels page reads DOL's OFLC wage search live.
What these numbers don't say
4 notes
- The code is the identity
- This one is SOC 11-9111.00. Two SOC codes can carry the same job title, so a title that looks duplicated on the ranking is two different occupations. Match on the code when you're checking a specific filing.
- A median isn’t an offer
- It's the middle of all 209 wages committed to for this occupation across the country, entry level and principal alike. The same role's medians swing hard by worksite, which the state map shows directly.
- Approval isn’t about the occupation
- The denial rate moves with what happened in the filing rather than with the job title, so nothing here is a property of Medical and Health Services Managers. The measured factors are on the denial risk page, published as separate rates.
- Nothing here is pending
- All 209 counted here carry a decision date, because every case in DOL's disclosure files does, so a case still waiting is in none of them. The largest filer of this occupation is HENRY FORD HEALTH SYSTEM. Where the queue stands today is on the processing times page.
The window these figures cover: DOL's PERM disclosure files for fiscal years 2024 to 2026, through the third quarter of 2026, 373,939 decided cases. Nothing pending is counted here. How each figure is built
Weighing an offer?
Compare it against this median, then check the state map, where the same occupation's medians swing hard by worksite.
Setting one?
All 1,410 occupations sort together on the wages page, and denial rates show how outcome moves with the offered wage.
Filings newer than DOL's last published file can't be attributed to this occupation until DOL publishes them. The live list on the case search page carries them by employer.
Case data: DOL quarterly disclosure files (flag.dol.gov) · data through Jun 30, 2026 · quarterly
Employers and firms: Derived from DOL's disclosure files · data through Jun 30, 2026 · rebuilt with each quarterly load
O*NET occupation data: O*NET Database, USDOL/ETA (onetcenter.org) · data through Aug 16, 2026 · twice a year
BLS market pay: BLS Occupational Employment and Wage Statistics (bls.gov) · data through May 31, 2025 · yearly, each spring
BLS employment projections: BLS Employment Projections (bls.gov) · data through Dec 31, 2025 · yearly, each autumn
DOL wage tables: DOL OFLC wage data downloads (flag.dol.gov) · data through Jul 1, 2026 · yearly, each july
What each source includes
Case data: Decided PERM cases only. A case still waiting isn't in here, so counts and durations describe finished cases.
Employers and firms: Employers, law firms and occupations ranked from decided cases only.
O*NET occupation data: What O*NET says each occupation is and takes: its description, tasks, Job Zone and the education workers report. A description of the job everywhere, not of any one employer's opening.
BLS market pay: What employers report paying everyone in each job, nationally, by state and by metro, from BLS's yearly survey (May of the year named). Citizens and immigrants alike; not PERM offers.
BLS employment projections: BLS's ten-year projection of each job's employment and yearly openings, and the entry education it calls typical. A projection, not a count.
DOL wage tables: The four prevailing wage levels DOL publishes for every job in every area, each wage year from 2021-22, as DOL's own tables print them. The floors an offer is held to, not what anyone was paid.
Cite this page
Waiting on a PERM case?
- When it'll likely be decided
- An email when DOL moves it