Women make up a large portion of the healthcare workforce, but have historically been underrepresented in C-suite and financial roles. However, that has begun to change, with more women now holding CFO roles at hospitals and health systems across the country.
The lessons these women leaders have picked up along the way haven’t always been in a textbook or a training program, but instead came from setbacks, missed chances or moments when they had to decide if they should speak up or hold back.
For women just entering the industry, that experience can often be the most important tool available.
Becker’s connected with four women hospital and health system CFOs to discuss the lessons they’ve learned the hard way over their career and what they want the next generation of women in healthcare finance to know.
Editor’s note: Responses have been lightly edited for length and clarity.
Question: What’s one lesson you learned the hard way that you’d want every woman starting out in healthcare finance to know?
Jennifer Alvey. Senior Vice President and CFO at Indiana University Health (Indianapolis): When I was younger, I read Sheryl Sandberg’s, “Lean In: Women, Work, and the Will to Lead,” and took its message to heart. As a woman working in a male-dominated field, I felt I always needed to lean in, speak up and lead with confidence.
As female representation has increased and with experience, I’ve learned another important skill: knowing when to lean in and when to match the pace, tone and intensity of the team. Leadership isn’t always about being the strongest voice in the room. Sometimes the greatest contribution is being an effective collaborator and partner. The key is being thoughtful about what the team needs from you in that moment. That doesn’t mean changing who you are to fit in. It means recognizing that the work isn’t about any one of us. It’s about the shared goals and purpose of the team and the organization. Effective leaders know when to lead from the front and when to meet the team where it is.
Tonya Brown. CFO of UNC Hospitals (Chapel Hill, N.C.): One lesson I learned the hard way is that working hard and delivering results does not automatically mean your value will be recognized or your voice will be heard. You must have the confidence to advocate for yourself, trust your judgment, and make your voice part of the conversation. My advice to women entering healthcare finance is to never underestimate the value of what you bring to the table or feel you must compromise your authenticity to lead effectively.
Maria Arias-Clarke. CFO of NYC Health + Hospitals/Queens (Jamaica, N.Y.): If I could offer my younger self one piece of advice, it would be this: Do not mistake waiting to feel
ready for being prepared to lead. Some of the most consequential moments in your career will require you to speak before you have complete certainty, challenge a perspective, raise an uncomfortable question or bring attention to something others may have overlooked.
In healthcare finance, silence can be costly. Your perspective has value, and you should never allow the pursuit of perfection to diminish your willingness to contribute. Confidence is not a prerequisite for having a seat at the table; it is something you develop by having the courage to use your voice. I would also encourage women entering this field to resist defining healthcare finance solely by its numbers. A spreadsheet may capture the figures, but it cannot, on its own, tell the full story of the operation behind them. Understanding how a hospital functions, how resources are deployed and how financial decisions affect clinical operations is what transforms financial expertise into strategic leadership. Our greatest contribution is not simply reporting what the numbers say, but interpreting what they mean and translating that insight into decisions that strengthen operations, advance organizational priorities and ultimately support patient care.
Michele Cusack. Executive Vice President and CFO at Northwell Health (New Hyde Park, N.Y.): Early on, do not stress if you do not know your ultimate career destination. You do not need a perfect road map on day one. Let your journey unfold organically. Focus on building your foundation and seizing opportunities as they present themselves — or actively creating them when you spot a gap. Along the career journey you may surprise yourself by what you truly come to enjoy. When I started my career, I never imagined or planned on becoming the CFO of this enterprise, but today I couldn’t imagine being anywhere else.
