This study is designed to investigate the development of managerial activities and competency of chief executive officers ( CEO ) or superintendents in major healthcare organizations. We used activity competency model ( ACM ) to perceive the importance of managerial activities, skills and knowledge required for them. A survey was designed based on ACM for data collection which includes twenty managerial activities and fourteen competency required to effectively perform these activities. Through personal interviews and questionnaire, the data were collected from ten CEO or superintendents for analysis. The results from this study implicate the setting organizational vision and mission, crisis management, positive ethical work and inspiring or supporting subordinates as the most important managerial activities; analysis and problem solving, leadership, communication and coordination and system thinking as the most important competency. These results can be served as guideline for recruiting and training the chief executive officers of healthcare organizations.