From Kitchen to Corner Office: How UC Davis Medical Center CEO Ann Madden Rice Rose Through the Ranks

When Ann Madden Rice was 16 years old, she got a taste — almost literally — of her first job. She worked in the kitchen of Mercy Medical Center in Mason City, Iowa, where her mom was also a nurse.

She went to Mercy right after high school let out, and on the weekends, she started her shifts at 6 a.m. to get breakfast prepared. Ms. Rice was grateful she even had a job — work opportunities for high school students were scarce at the time — but little did she know her modest kitchen job in at the local community hospital would be a training, of sorts, for the rest of her professional financial career.

"I learned about special diets for patients. I learned a little bit about the supply chain, quality issues and food safety," Ms. Rice says. "And it was hard work."

Ann Madden Rice, CEO of UC Davis Medical CenterFor the past five years, Ms. Rice has been the CEO of University of California Davis Medical Center in Sacramento, a 631-bed teaching hospital with an annual budget of more than $1 billion. Ms. Rice didn't make the jump from kitchen attendant to academic medical center CEO in one fell swoop — she has more than 20 years of hospital C-level experience, mostly as CFO — but her home state of Iowa was where her career first took off.

She graduated from the Iowa State University with a bachelor's degree in accounting and then followed her husband, Tom, to the University of Iowa. She was pursuing a master's in accounting while Tom worked on his PhD in political science. Ms. Rice met her husband in college at the Amalgamated Spirits and Provision Company, a now-defunct steak and seafood restaurant, where she had the ultimate résumé-clinching job: bartender.  She dished out the drinks, and her husband ran with the wait staff. "It was a good job," Ms. Rice says, laughing. "I worked all through college, and it was fun working with people your age."

After graduating with her master's in accounting, she became a financial analyst at the University of Iowa Hospitals and Clinics. Ms. Rice says this first post-graduate job was good exposure to tasks outside of the stereotypes of finance and spreadsheets, such as taking inventory of hospital supplies. "I was crawling under hospital beds looking for serial numbers, and it was a real eye-opener," Ms. Rice says. "I got into parts of the hospital that I normally wouldn't have seen as a financial analyst."

She then moved to Vermont to work as a financial analyst with the Medical Center Hospital of Vermont in Burlington, now known as Fletcher Allen Medical Center. While there, she started an internal audit function and helped set up a retail pharmacy — another hospital that allowed her to learn the basics of healthcare finance while initiating her own projects. "That was a fantastic move for me because their controller, Chris Weinheimer, hired me, and he just provided me with a lot of opportunities that were outside of the traditional finance roles," Ms. Rice says.

She stayed at Fletcher Allen for nearly nine years, but then Ms. Rice had a chance for her first CFO position. She took the job, which was at Central Vermont Medical Center in Berlin. "That was also my first community hospital," Ms. Rice says. "That was great, too, when you're at a small hospital because you can really get connected with the medical staff and the nursing staff. It's a way to really know the community and the people that you're working with and the people that you're caring for."

Ms. Rice then returned to Iowa to continue to her municipal hospital CFO experience, this time at Mary Greeley Medical Center in Ames. She says everything was very transparent at Mary Greeley — board meetings were televised and attracted a lot of media scrutiny — but she says it was one of her most rewarding experiences during her hospital CFO career. "That actually helped me to prepare to be a CEO because I learned to make our financials very understandable for the public," Ms. Rice says. "I would meet with reporters individually to go over financials. Based on their questions, it helped me anticipate what items are the most confusing about healthcare finance to people outside the field. It taught me how to explain things that are more believable and relevant to the public's experiences."

After three years at Mary Greeley, Ms. Rice's professional life turned full circle. The University of Iowa Hospitals and Clinics named her CFO in 1999, as she returned to the grounds of her first post-college job, and after four years, she became COO. When asked how she has been able to guide the financial direction of several different hospitals as CFO, Ms. Rice mentioned her previous experiences and role models played a large factor, but she learned communication can never be overlooked. "Effective CFOs have good communication skills," Ms. Rice says. "People are not always trusting of how financial numbers are reported. It's complex. A good CFO will communicate well to establish trust, so whoever is receiving that financial information can have confidence they are getting accurate financial information."

A fellow of the American College of Healthcare Executives and a distinguished member of the Healthcare Financial Management Association, Ms. Rice has also placed a big emphasis on learning from her healthcare peers to shape her career. "I think getting involved with professional societies is really important, for early careers in particular, because it's another pathway to become a leader," Ms. Rice says.

Ms. Rice did not think her early hospital kitchen career would lead to the oversight of one of the largest teaching hospitals in Northern and Central California, but she says she would not have cooked it up any other way. "I've had a really rewarding career," Ms. Rice says. "And having my financial background has been very helpful for me."

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