I think the point in general is that rights managed just means that you get a limited set of rights for a limited time, geography, page size, page position or other conditions.
It doesn't say anything about the specifics of any given license, just that the licensor knows and tracks every use of the image. Unlike with Royalty Free where you not only don't get paid for additional uses, but have no idea what's been done with the image (unless you happen upon it or the designer tells you).