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Key Responsibilities and Required Skills for X-Ray Manager

💰 $ - $

🎯 Role Definition

The X‑Ray Manager (Radiology Manager) is responsible for leading and optimizing the X‑ray and general radiography services within a hospital, imaging center, or outpatient clinic. This role combines clinical oversight, operational leadership, regulatory compliance, equipment and vendor management, and staff development to deliver safe, efficient, high-quality diagnostic imaging. The X‑Ray Manager ensures patient and staff radiation safety, monitors performance metrics (throughput, turnaround time, dose indices), and collaborates with clinical and administrative stakeholders to support patient care, service growth, and accreditation readiness.

📈 Career Progression

Typical Career Path

Entry Point From:

  • Senior Radiologic Technologist / Lead X‑Ray Technologist
  • Imaging Supervisor or Charge Technologist
  • Radiology Team Lead with strong operational experience

Advancement To:

  • Director of Diagnostic Imaging / Imaging Services
  • Radiology Operations Manager / Clinical Operations Director
  • Administrative Director, Imaging & Ancillary Services

Lateral Moves:

  • CT Manager / MRI Manager
  • Mammography Manager / Nuclear Medicine Manager
  • PACS / RIS Administrator or Clinical Informatics Specialist

Core Responsibilities

Primary Functions

  • Lead day‑to‑day operations of the X‑ray/radiography department by managing staffing levels, creating weekly and holiday schedules, assigning shifts and on‑call rotations, and ensuring appropriate technologist coverage to meet patient volume and service goals.
  • Supervise, coach, and evaluate a multidisciplinary imaging team (radiologic technologists, tech assistants, clerical staff), conduct regular performance reviews, implement corrective actions and professional development plans, and foster a culture of continuous improvement and patient‑centered care.
  • Maintain clinical quality and patient safety by implementing and auditing evidence‑based imaging protocols, reviewing image quality, monitoring repeat rates, and coordinating with radiologists to standardize exposure parameters and positioning techniques.
  • Ensure compliance with radiation safety regulations and lead radiation dose management efforts: track dose indices (e.g., DAP, CTDI when applicable), investigate dose anomalies, maintain records of occupational monitoring, and liaise with the Radiation Safety Officer and state regulatory bodies.
  • Oversee equipment lifecycle management including preventative maintenance scheduling, service contracts, warranty management, performance acceptance testing, equipment upgrades, and capital planning for new X‑ray systems and digital radiography suites.
  • Manage PACS and RIS workflows related to X‑ray services: ensure study routing, image availability for radiologists, correct DICOM tagging, troubleshooting interfacing issues and coordinating with IT and vendors to resolve system outages and optimize uptime.
  • Drive operational KPIs such as exam throughput, turnaround times for preliminary and final reports, patient wait times, room utilization, cost per exam and technologist productivity metrics; prepare weekly/monthly operational dashboards and executive summaries.
  • Lead quality assurance (QA) and quality control (QC) programs: schedule and document regular phantom testing, image quality assessments, equipment performance checks, and corrective actions to meet ACR, JCAHO, and state inspection standards.
  • Maintain regulatory and accreditation readiness for ACR, TJC/JCAHO, CMS and state surveys: prepare documentation, lead mock surveys, respond to citations, and implement action plans for compliance gaps.
  • Manage departmental budgets: develop and monitor operating budgets, control supply costs, analyze charge capture and revenue cycle issues for imaging procedures, and recommend cost‑effective equipment and consumables purchasing.
  • Serve as primary liaison between radiology leadership, referring physicians, nursing units, emergency department, outpatient clinics and other departments to optimize imaging order triage, STAT exam prioritization, and patient flow.
  • Oversee credentialing, licensing and continuing education for all technologists; ensure ARRT registration and state licensure are current, coordinate annual competency assessments and facilitate modality cross‑training (mobile radiography, fluoroscopy support).
  • Implement and lead infection control processes and patient safety initiatives in imaging environments, including mobile X‑ray in critical care, trauma bays, and isolation rooms; enforce PPE policies and equipment disinfection procedures.
  • Coordinate vendor relationships and contract negotiations for equipment procurement, service agreements, and third‑party maintenance providers; evaluate proposals, oversee installation, and manage vendor performance metrics.
  • Develop and maintain departmental policies and procedures for operative, technical and administrative tasks: exam protocols, patient identification, consent for fluoroscopy procedures, and escalation pathways for adverse events.
  • Oversee scheduling workflows and front‑desk functions to maximize appointment utilization, reduce no‑shows and optimize same‑day imaging capacity; implement scheduling system best practices and patient communication protocols.
  • Lead initiatives to improve patient experience: implement patient education, improve signage and intake processes, reduce exam delays, capture patient feedback and drive service recovery when issues arise.
  • Coordinate with HIM and billing teams to ensure accurate CPT/ICD coding, modifiers for radiologic procedures, appropriate charge capture, and resolution of denials related to imaging services.
  • Manage incident reporting, root cause analysis and corrective action plans for clinical or operational events (radiation safety incidents, image mislabeling, patient falls), and deliver training to prevent recurrence.
  • Champion process improvement projects (Lean, Six Sigma, PDSA cycles) to reduce exam cycle times, improve image turn‑around, and streamline patient throughput—define project scope, track measures, and document outcomes.
  • Oversee tele‑radiology and remote reading logistics for after‑hours coverage, credentialing of remote radiologists, secure image transmission, and service level agreements to maintain 24/7 diagnostic availability.
  • Maintain inventory control for radiology supplies and accessories, monitor capital and expendable supply usage, implement cost reduction strategies without compromising clinical quality.
  • Lead multi‑disciplinary committees (radiation safety committee, infection control, equipment procurement board) and participate in hospital leadership meetings to align imaging priorities with institutional goals.
  • Prepare regular reports for executive leadership on imaging performance, quality metrics, capital needs, service line growth opportunities, and risk areas requiring escalation or investment.

Secondary Functions

  • Support ad-hoc data requests and exploratory data analysis.
  • Contribute to the organization's data strategy and roadmap.
  • Collaborate with business units to translate data needs into engineering requirements.
  • Participate in sprint planning and agile ceremonies within the data engineering team.

Required Skills & Competencies

Hard Skills (Technical)

  • Current ARRT (American Registry of Radiologic Technologists) registration and state radiologic technologist licensure; familiarity with continuing education requirements.
  • Deep knowledge of X‑ray modalities: general radiography, digital radiography (DR), computed radiography (CR), mobile/portables, and fluoroscopy support.
  • Proficiency with PACS (e.g., Sectra, Agfa, GE Centricity, Philips IntelliSpace) and RIS/EHR integrations (Epic, Cerner, MEDITECH) and experience troubleshooting DICOM and HL7 interfaces.
  • Radiation safety and dose management experience, including familiarity with ALARA principles, occupational monitoring, and dose tracking software.
  • Experience with QA/QC processes, phantom testing, and regulatory documentation to meet ACR and state inspection standards.
  • Working knowledge of ACR accreditation processes, JCAHO/CMS requirements, and state radiology regulatory frameworks.
  • Strong financial acumen: departmental budgeting, cost analysis, revenue cycle basics, CPT/ICD coding awareness for radiology procedures, and contract/vendor cost negotiations.
  • Technical skills in equipment lifecycle management: specs evaluation, acceptance testing, service agreements and capital procurement justification.
  • Data literacy: ability to generate operational dashboards with Excel, Power BI, Tableau or similar tools and interpret KPIs relating to throughput, productivity, and quality.
  • Familiarity with infection control best practices for imaging departments and safe transport/positioning of patients in various clinical settings.
  • Basic IT literacy for problem‑solving PACS/RIS outages, working with IT on backups, cybersecurity best practices related to PHI, and escalation pathways.

Soft Skills

  • Proven leadership and people management skills: hiring, mentoring, conflict resolution, and performance management.
  • Excellent verbal and written communication skills for interaction with clinical teams, executives, vendors, and patients.
  • Strong organizational and time‑management skills; ability to prioritize competing operational demands in a fast‑paced environment.
  • Problem solving and critical thinking; capacity to lead root cause analysis and implement corrective actions.
  • Change management and project leadership skills—experience driving clinical and operational change across a multidisciplinary team.
  • Customer service orientation with empathy for patient needs and the ability to de‑escalate stressful or sensitive encounters.
  • Collaborative mindset and ability to work cross‑functionally with IT, facilities, nursing, radiology, finance and procurement.
  • Attention to detail and commitment to maintaining accurate documentation, QA logs, and regulatory records.
  • Adaptability and resilience under pressure—managing after‑hours events, equipment failures or high‑volume surges.
  • Ethical judgment and integrity with respect for patient privacy and HIPAA compliance.

Education & Experience

Educational Background

Minimum Education:

  • Associate Degree in Radiologic Technology (AAS) or equivalent accredited radiography program.
  • Current ARRT certification and state licensure.

Preferred Education:

  • Bachelor's Degree in Radiologic Sciences, Healthcare Administration, Health Services Management, or related field.
  • Certificate or training in leadership, management, Lean/Six Sigma, or radiation safety officer coursework.

Relevant Fields of Study:

  • Radiologic Technology / Radiography
  • Healthcare Administration / Health Services Management
  • Diagnostic Medical Imaging
  • Nursing or Allied Health (with imaging leadership experience)

Experience Requirements

Typical Experience Range: 3–7 years of progressive radiology experience with at least 1–3 years in a supervisory or lead role.

Preferred:

  • 5+ years of clinical radiography experience with demonstrated people management and operational leadership.
  • Prior experience managing X‑ray/imaging services in a hospital, outpatient imaging center, or multisite health system.
  • Demonstrated success with PACS/RIS workflows, quality programs, accreditation activities and budgetary responsibility.
  • Experience implementing process improvements and leading cross‑functional projects to improve patient flow and imaging quality.
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