An HIM director runs the health information management department: the team that, in BLS's description of health information managers, keeps databases of patient records complete, accurate and accessible only to authorized personnel.
BLS counts health information managers inside medical and health services managers, an occupation it projects to grow 24.2% from 2025 to 2035, with about 62,300 openings a year.
This guide covers the duties, how the manager and director titles differ, the RHIA credential AHIMA sets for health information management, the career path and pay.
HIM director duties
BLS describes health information managers — part of the medical and health services managers occupation — as the people who ensure that databases of patient records are complete, accurate, and accessible only to authorized personnel.
An HIM director carries that responsibility for an entire department, answering for the records operation behind patient care.
The department's daily work follows the records occupations BLS profiles.
Medical records specialists may serve as gatekeepers for access to patient files, ensuring access only by authorized people and retrieving, scanning and transmitting files according to established protocols.
BLS also lists ensuring the confidentiality of patients' records and maintaining and retrieving records for insurance reimbursement among medical records specialists' typical duties.
O*NET counts releasing information to persons or agencies according to regulations as a core task of medical records specialists.
Some of that work runs on regulatory clocks.
Under the HIPAA right of access (45 CFR 164.524), a covered entity must act on an individual's request for access no later than 30 days after receipt.
The same rule allows a covered entity that cannot meet the access deadline to extend it by no more than 30 days, subject to conditions.
Deadlines like that one are the operational floor an HIM director's team works above.
Staffing is the other standing item on the desk.
In AHIMA's 2023 workforce survey, run with NORC and surveying about 2,500 health information professionals, 66% of respondents reported persistent staffing shortages at their workplaces over the prior two years.
Unfilled positions were just as persistent in that survey: 83% of respondents saw them increase or persist at their organizations over the past year.
The same survey put technology on the leadership agenda, with 75% of respondents calling upskilling the health information workforce essential given growing AI and machine learning adoption.
AHIMA's workforce policy statement adds a setting dimension: rural, urban, underserved and critical access hospitals are often unable to pay and retain health information professionals compared with care settings in higher-income areas, and remote work has exacerbated the issue.
Put together, the desk covers record quality and access control, the department's regulatory deadlines, its staffing and retention, and the systems and skills its team runs on.
HIM manager vs HIM director
The data counts one occupation, not the director title.
Health information managers sit inside medical and health services managers (SOC 11-9111), and BLS publishes no HIM-director-only wage — for any wage figure attached to the title, that occupation is the closest available group.
Titles do not map cleanly onto it either.
O*NET's sample of reported job titles for health information technologists and medical registrars (29-9021) includes Medical Records Director, so a director title can appear below the management classification.
Federal classification guidance shows the same variation.
OPM's standard for medical records positions notes that medical records administrators manage most records departments, while in some facilities an experienced medical records technician may head the department.
If the two titles differ in practice, the visible difference is scope.
BLS describes some health information managers advancing by taking on additional responsibilities, such as for an entire hospital's information systems — a direction of travel from owning a team or function toward owning the department and its results.
Because the data counts one occupation rather than two titles, any pay figure attached to either title reflects that whole group, not a director-specific number.
Credentials: AHIMA's RHIA
AHIMA, the professional association for health information, describes itself as a global nonprofit with more than 67,000 members and more than 100,000 credentials in the field.
The credential closest to the HIM leadership seat is AHIMA's RHIA.
Eligibility runs through accredited HIM education.
One route is completing the baccalaureate-level academic requirements of a CAHIIM-accredited HIM program; master's-level HIM programs and CAHIIM-approved post-baccalaureate certificates also qualify.
The exam has 150 questions — 130 scored items and 20 pretest items — and candidates get three hours and thirty minutes to complete it.
It costs $229 for AHIMA members and $299 for non-members, as of October 13, 2026.
Delivery is fixed rather than flexible: AHIMA's coding and HIM exams, including the RHIA, must be scheduled at a Pearson VUE testing center, and only the CDIP, CHPS and CHDA exams offer at-home remote proctoring.
The field behind the credential is countable.
AHIMA reported 13,848 certified RHIAs as of December 31, 2025, alongside 26,128 certified RHITs — the associate-level credential whose eligibility runs through an associate-degree-level CAHIIM-accredited HIM program.
Keeping the credential means continuing education.
AHIMA credentials are maintained by earning a specified number of CEUs during a two-year certification cycle, calculated on clock hours at 0.5 CEU for every 30 minutes of attendance or participation.
Taking an AHIMA certification exam is voluntary, per AHIMA's candidate guide.
BLS adds that, for health information technologists seeking to advance, employers may require a higher-level certification or a bachelor's or master's degree in health information management or a related field — which is where the RHIA enters a career plan.
Confirm credential details with AHIMA
The path into HIM leadership
The route BLS describes starts in the records occupation.
Medical records specialists may advance to health information technologist or medical registrar roles, or to medical and health services manager roles, after completing a higher certification program or earning a degree in health information technology.
The technologist rung is its own occupation — health information technologists and medical registrars (SOC 29-9021).
BLS's Employment Projections expect it to grow from 42,000 to 48,600 jobs between 2025 and 2035, a 15.9% increase, with about 3,000 openings a year.
Entry to that rung typically takes an associate's degree, and BLS puts its median wage at $68,020.
Hospitals lead its employer mix: of the about 42,000 jobs in 2025, hospitals employed 46% of these technologists and medical registrars, and offices of physicians 10%.
BLS says health information technologists and medical registrars sometimes advance to become medical and health services managers.
From there, the management requirements apply: a bachelor's degree and less than 5 years of related work experience are the typical entry requirements BLS lists for the occupation.
Prospective managers also typically need work experience in an administrative or clinical role in a hospital or other healthcare facility, per BLS.
On the technologist rung, BLS says employers may require workers seeking to advance to have a higher-level certification or a bachelor's or master's degree in health information management or a related field.
That is the point where the RHIA, or a higher HIM degree, enters a career plan.
- A bachelor's degree — the typical entry education BLS lists for medical and health services managers
- Less than 5 years of related work experience, per the BLS Employment Projections table
- Work experience in an administrative or clinical role in a hospital or other healthcare facility
- A higher-level certification or a bachelor's or master's degree in HIM or a related field, which BLS says employers may require of health information technologists seeking to advance
Scope then grows with the seat.
BLS's own caveat on the advancement sentence is simply "Requirements vary by facility."
That flexibility helps explain why postings for this seat read differently across hospitals, physician organizations and other settings.
HIM director pay
BLS publishes no HIM-director-only wage.
The closest available group is medical and health services managers (SOC 11-9111) — all healthcare managers, not HIM directors alone — so treat the figures as occupation-wide rather than title-specific.
The median annual wage for that occupation was $123,860 in May 2025.
The lowest 10% earned less than $73,390, and the highest 10% earned more than $224,340.
The outlook side is large: BLS's Employment Projections expect the occupation to grow 24.2% between 2025 and 2035, from 640,400 to 795,500 jobs, with about 62,300 openings a year.
The openings figure counts the whole occupation, not health information alone.
Find HIM director jobs
Browse current HIM director jobs on MedicalBillingHires, or look at the records-side roles on BLS's advancement path — medical records specialist and health information technologist — as the rungs below this seat.
Career information, not coding, billing-compliance, legal or tax advice. Credential and exam details here come from AHIMA's pages — confirm current requirements with AHIMA, and pay figures with BLS.