Background: With regard to the importance of managers’ competency in organizational success, a valid tool should exist for assessing these competencies. Objective: To validate, conceptualize, and localize acompetency assessment tool for the managers of healthcare networks in Zanjan Province, Iran. Methods: This was a descriptive-analytical study. In the first stage, the validity and reliability of ACHE Healthcare Competencies Assessment Tool were examined via content validity, Cronbach’s alpha, and test-retest methods. The data of the first stage were analyzed in Excel 2010 and SPSS 18. In the second stage, a sample of 350 was selected, and the factors affecting the managers’ competency assessment were identified. In the second stage, the data were analyzed in Amos 23. Results: After removed 235 out of the 302 questions due to their low content validity, 67 questions in four main dimensions remained. The content validity index of the final questionnaire was 0.84 and acceptable. The results showed that the final questionnaire is reliable (α = 0.986) and repeatable (p < 0.001). In second stage, nine new factors with their relevant scales were identified. The results of first- and second-order confirmatory factor analysis also demonstrated the good fit of the data with the factor structure. Conclusion: It can be concluded that the localized tool for assessing the competency of Zanjan health network managers has a good fit. Healthcare organizations can use the results of this study to assess what competencies are important for new managers and how these competencies should be assessed as careers progress.