In this weekly feature, the editors of SpringBoard highlight one career in the health care professions–including a basic description, educational requirements, core competencies/key skills needed, and related web sites and professional organizations where you can find more information!

101 Careers in Public Health

Job Description

The EMS system includes government agencies at the local, regional, state, and even national levels. At each level, there are EMS directors or chiefs who are responsible for making sure the system works effectively. On the local level, many cities and small towns have EMS directors who supervise personnel, handle scheduling, and verify that all workers have the proper certifications. At the county level, EMS agencies oversee the work of smaller local departments and set and enforce policies and regulations. State agencies certify EMS personnel and handle statewide coordination and regulation of EMS.

Typical responsibilities for EMS directors include making decisions about spending, reviewing personnel or departments, ensuring that training and safety programs are in place, and coordinating with the leaders of other emergency services including the fire department (if separate from EMS) and nearby EMS systems. The director also must ensure that the department, its various elements, and any contractors all comply with local, state, and national laws and regulations. EMS directors make decisions about purchasing ambulances or hiring ambulance companies; work with hospitals to ensure high-quality emergency care; and plan for emergencies such as natural disasters or attacks. Policy development is another big part of the job, especially at higher levels.

Running an EMS system is essentially an office job. Some directors who are trained as emergency responders also respond to emergency calls, but as the administrative responsibilities become more complex, this may not be an option.

Education and Certification

An EMS director is usually an experienced manager who has risen through the ranks, either locally or elsewhere. Depending on the specific job, it may be necessary to be certified as a paramedic or licensed as a nurse. Some local jobs require additional emergency-response certifications or even firefighting skills. However, many EMS administrators are not paramedics, firefighters, or emergency medical technicians. Especially at higher levels, the director needs a strong understanding of public policy, administration, and how medical systems are run. Degree requirements vary, but large city or county systems may ask for at least a bachelor’s degree in public administration or a business-related field, with a master’s degree preferred.

Core Competencies and Skills

  • Ability to remain calm under pressure
  • Ability to handle multiple tasks and responsibilities at once
  • Excellent interpersonal skills
  • Strong management ability and financial skills
  • Good political and negotiating skills
  • Patience with politics and red tape
  • Ability to understand and interpret data
  • Knowledge of EMS systems and of related local, state, and national laws and regulations 


Compensation varies greatly, but a salary in the range of $50,000 to $80,000 per year for a city or county EMS director is not uncommon. The director of EMS for a large county or metropolitan area can earn more than $100,000 per year, although most salaries are not this high.


EMS directors work for cities, counties, states, and the military, and there are also opportunities to shape EMS services at the federal level. EMS may be part of the health department or the public safety department, it may be run by or affiliated with the fire department, or it may be a separate agency. There are also director or coordinator roles at ambulance companies and medical centers.

Employment Outlook

There are often jobs available at the local level, although finding an opening in a specific location may be a challenge. Top jobs at the county and state levels are limited and open only to those with strong experience and credentials. However, there are many administrative positions within EMS, particularly in larger systems, which can serve as steppingstones toward jobs with high levels of responsibility.

For Further Information

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