Healthcare organizations, health management professional associations, and educational institutions have begun to examine carefully what it means to be a fully competent healthcare executive. As a result, an upsurge in interest in healthcare management competencies has been observed recently. The present study uses two critically important groups of informants as participants: health management practitioners and faculty. Using the nominal group process, health administrators identified critical environmental issues perceived to have an impact on healthcare executives today. These issues were employed in a card-sort assessment and a survey was administered to a nationwide sample of health administrators. These data were used to create a map and five clusters of the environmental landscape of healthcare management. These clusters of environmental issues provided a framework for having groups of administrators and faculty members generate and rank perceived behavioral competencies relative to each cluster. Implications for healthcare management practice, education, and research are discussed.