Counter Offers

Considering the Counter-Offer Conundrum

You took a chance and you explored your Medical Management employment options, maybe with the help of a specialized recruiting firm. You sent out resumes, went through multiple phone-screens, attended several in-person interviews, and finally the lightening struck and you got a great job offer from a new health plan or hospital system! You are not looking forward to this, but you want to do the right thing and give your boss professional notice you will be leaving. That’s when the unexpected occurs: you now have a counter-offer from your current employer to consider alongside the offer from the new company.

If you have done any research at all on the pros and cons of accepting a counter-offer to stay at your current employer vs. accepting a new job offer, you have probably noticed that most advice is to steer clear from counter-offers like the plague.

Based on my extensive experience this advice is true: accepting a counter-offer is inherently unwise. But why should it be? You are already working for the employer and have not really left that comfort zone. It’s not like you HATE your current job; and let’s face it: you’re enticed by the allure of more money or expanded fringe benefits – all to just keep doing the same thing! You would get to continue working with close associates you have grown to know and like. All the natural anxiety about the unknowns of the new position (culture, benefits, commute, boss, etc) would not even be a factor. How could accepting the counter offer be a bad thing?

Let’s begin with the fallacy that you are being given a counter-offer to stay because you are valued. More often than not, this is simply untrue. The real reason you were given a counter-offer is because your boss simply does not want to go through the headache of recruiting and training your replacement, not to mention deal with the lack of productivity and possibly loss of revenue while he/she endures the hiring process. Even if they hired an experienced RN Case Manager (as an example) to replace you, it still takes time to find and hire that person, and to on-board them with internal company polices, etc. Let me repeat, your counter-offer is NOT about your worth to the company as much as the inconvenience your departure would bring.

Now let’s stack that one huge red flag against some other reasons for not accepting a counter-offer, and taking the new offer of employment instead:

1 – Your loyalty is now in question and your desk is (figuratively) already packed for you. Keep in mind that you’ve just told your boss, let’s say it’s the Director of Utilization Review, that your job is undesirable (you might even be leaving for a competing Managed Care Organization – hiring managers love losing out to their rivals). Now that you have let that genie out of the bottle, it is hard to put it back. The perception you are looking to leave is now out there and nothing can change it. Even if you choose to accept the counter-offer and stay, your boss is secretly thinking it is just a matter of time before you attempt to resign again. Meanwhile, he or she is putting their ducks in a row to preempt that possibility by grooming someone internally for your position or networking for your replacement.

2 – It’s never just about better benefits and more money. What keeps professionals happily working at their employer is NOT just the salary or benefits. You stay because you like the clinical and non-clinical peers you work with; you get along with your boss; the company has a compelling function or vision; the work is interesting and challenging – if you have ever worked in a setting like this you know that money becomes secondary to these factors. Everyone (especially healthcare professionals) spends much of their life away from home and at work, so they innately desire favorable workplace circumstances over money most of the time. So before you accept that counter-offer, remember what drove you to explore other options in Managed Care. At some point the dissatisfaction with the work, work place, superiors or co-workers will overshadow any increase in salary or enhanced benefits.


3 – Accepting a counter-offer does not really change the factors motivating you to leave. This reminds me of an 80’s song by Naked Eyes called “Promises, Promises.” Sure your boss makes you an attractive counter-offer and promises that big changes will be made. “Was it the unreasonable caseload that was driving you crazy? I will speak with the Supervisor of Care Coordination right away to restructure how this process works!” In the end though, ask how realistic is it that promises made in the moment will really pan out? (See reason # 1 above.) Was it ever really that one reason you gave your boss (like caseload), or is it a deeper issue with company culture that caused it to be a factor in the first place? Even worse, totally new issues might arise that ultimately bring back the same sour taste that you originally felt.

4 – You’ll get an increase in salary, but most likely no merit raise anytime soon. Fiscally responsible employers give 1-3% merit raises annually. That is probably the pool of money they tapped into to offer an increased salary on the spot. Chances are pretty solid that you won’t be seeing a raise anytime soon if you accept a counter-offer.

5 – If you do accept a counter-offer, you just burned a bridge with that potential new employer. You took the time to apply, interview, and go through the necessary steps to ultimately get a job offer. The potential employer also used considerable resources to evaluate and interview you. They selected you out of all the other CPHQ certified Quality Improvement candidates they interviewed. Your potential new boss was excited to be done interviewing and hiring for a while and just ready to get back to work. Declining their offer will not leave you in their good graces (definitely not in the short-term) and you may have burned a bridge for any future consideration as well.

In conclusion, there is really no positive reason out there to accept a counter-offer, and literally dozens of reasons not to. When in doubt, consulting with a company like CareNational and our trusted team of specialized recruitment professionals is probably a good idea. If you are a clinical or non-clinical professional in the Medical Management field, we’d love to hear from you! Feel free to contact us via email at or visit our website at