This study proposed an activity competency model (ACM) to investigate the perceived importance of managerial activities and skills required of three levels of nurse managers from three levels of hospitals. A survey instrument was designed based on the ACM for data collection that encompasses forty-two initial nursing management activities and twelve managerial skills required to effectively perform these management activities that were identified through literature review, job analysis, and iterative personal interviews with domain experts. Our findings indicate that the importance of nurse managerial activities is significantly different from the levels of management, but not significantly different from the levels of hospitals. In particular, top and middle levels of management perceived the human resources management related activities as more important than the supervisory management. Middle management perceived the importance of operation management significantly higher than supervisory management. Top management perceived the importance of goal setting & planning significantly higher than middle management. Middle management perceived the importance of goal setting & planning significantly higher than supervisory management. Supervisory management perceived the importance of material & environment management significantly higher than top and middle managements. The results from this study provide implication guidelines for management development programs, training, and the career planning for nurse managers. They also can serve as guideline for recruiting and selecting the effective nurse managers.