Healthcare Executives Sitting Around a Conference Table
Leadership Executive November 26, 2018

Career Report: Strategies for Healthcare Executives in the First 90 Days of a New Leadership Position

The first 90-120 days of a new leadership position are increasingly important. A successful start establishes momentum, displays early evidence of advancement potential, and sets the tone for your leadership style. This initial period is made more challenging by a healthcare environment that demands a delicate management balance. It is critical for leaders to react to the pressing issues of the day with decision-making speed while refining long-run strategies. The margins for error have narrowed. This B.E. Smith report offers five strategies to improve your chances of getting off to the best start and promoting your leadership career goals.

Quickly Assess the Organization’s Strategic Context

Healthcare is undergoing substantial change centered on a fundamental business model shift from volume- to value-based reimbursement. No care delivery organization is immune to the evolving landscape, and leaders must size up their particular strategic context to frame early decisions and mitigate risk. This year’s B.E. Smith Leadership Intelligence Report provided guidance on the major factors expected to influence healthcare organizations in 2018. Figure 1 shows healthcare executives placed a heavy focus on regulatory and financial pressures. Those two forces were also cited by over 40% as the most commonly anticipated causes of market disruption.


Another recent survey illuminated the top growth strategies being pursued: M&A (50%), launching new business lines (21%), revitalizing existing offerings (20%), and opening new facilities (10%). (1)

Determine What Needs to Get Done

Career_Report-Strategies_for_Healthcare_Executives_in_the_First_90_Days_of_a_New_Leadership_Position-2Armed with a sense of overall industry direction, leaders beginning a new role need to identify what tasks take precedence. Management initiatives tend to fall into a few major categories. B.E. Smith’s survey work on Interim Leadership’s top focal areas applies equally well to permanent positions. Figure 2 displays four of the most frequent priorities for new leaders.

New leaders should pinpoint early priorities with their managers and staff. Helpful questions include:

  • What are the most critical issues facing our organization for the next 12 months?
  • What changes are needed?
  • What roadblocks exist to achieving our objectives?

Understand Core Leadership Attributes and Roles

There are multiple facets to getting on a fast track to success. First, understand what leadership attributes the organization perceives as most desirable and work to develop those skills. B.E. Smith’s survey offers a good starting point for evaluation. As Figure 3 displays, respondents stated they are seeking a range of leadership skills, with Vision/Strategy and Integrity strongly preferred. This result reinforces the intensity of the strategic challenges facing organizations today.


The second aspect of approaching a new leadership role is to recognize and simultaneously pursue what Harvard Business Review identifies as the “five major tasks that leaders must undertake in their first few critical months” (2) (see Figure 4).

Career_Report-Strategies_for_Healthcare_Executives_in_the_First_90_Days_of_a_New_Leadership_Position-4It is vital new leaders synchronize with their organization and critical stakeholders on desirable leadership style and relevant cultural norms. Also, adopt a collaborative stance with the team while sizing up what it needs to maximize performance.

Set Specific Short- and Long-Term Goals

Another important step of new leaders is to translate their understanding of strategic directions and urgent needs into actionable objectives. An important contributor to a successful start in a leadership role is to accrue some quick wins. Recommended actions based on B.E. Smith experience include:

  • Convey a sense of urgency to help motivate team members.
  • Break down larger objectives into smaller ones. Research consistently underscores the efficacy of setting achievable 90- to 120-day goals to produce rapid results that reinforce success.
  • Be sensitive to the culture. Ensure objectives are consistent with the organization’s pace of change and decision-making norms.

Build Collaborative Networks

Career_Report-Strategies_for_Healthcare_Executives_in_the_First_90_Days_of_a_New_Leadership_Position-5Success in value-based care relies heavily on collaboration, whether to circumvent traditional organizational boundaries in order to innovate and reduce cost, or to implement initiatives such as population health management (PHM). Indeed, 57% of respondents in the B.E. Smith Leadership Intelligence Report indicated they have a PHM strategy in place or in implementation. Another survey found the chief challenges to PHM have a significant collaborative element, including patient/community involvement (24%) and developing partnerships (17%). (3)

Organizations are also increasingly expecting new hired or promoted healthcare executives to foster strong team decision-making quickly. McKinsey recommends a decision type called “crosscutting,” which is common in the current healthcare environment. It involves “a series of smaller, interconnected choices made by different groups … as part of a collaborative, end-to-end process.” (4)

Career_Report-Strategies_for_Healthcare_Executives_in_the_First_90_Days_of_a_New_Leadership_Position-6Healthcare executives can improve collaborative skills through multiple avenues:

  • Reach across departments and disciplines, clinical and administrative, to achieve results.
  • Focus on employee engagement; it’s a strong foundation for teamwork. The B.E. Smith survey revealed that 50% of executives believe management and colleagues have the greatest influence on engagement.
  • Proactively build your network of relationships, both inside and outside the organization. Offer to mentor and to be mentored.

What Can Organizations Do?

There are also several steps organizations can take to alleviate the early pressures on healthcare executives and help pave the way for success. Several time-tested strategies should be pursued, utilizing outside support when possible.

  • Clearly delineate objectives up front, reducing the risks of mismatched expectations.
  • Prepare staff and peers for the healthcare leader’s role and mission, especially where difficult change is part of the mandate.
  • Conduct regular assessments of new leaders’ progress and invest in their development.
  • Assign a mentor or Interim Leader to provide coaching as well as ensure a successful onboarding process.


Getting off to a quick and successful start is critical to both the healthcare executive and the organization. The five strategies described in this report offer proven strategies to add value and enhance progress.

Download a Copy of this Report Now


  1. T. Bannow, “Healthcare Execs Look to Make Deals in 2018,” Modern Healthcare, January 1, 2018.
  2. M. Byford, M. Watkins, L. Triantogiannis, “Onboarding Isn’t Enough,” Harvard Business Review, May-June 2017.
  3. “Population Health: Providers Still Struggling to Build Community Connections,” Modern Healthcare, Sept. 18, 2017.
  4. A. De Smet and C. Gagnon, “Organizing for the Age of Urgency,” McKinsey Quarterly, January 2018.


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Additional Executive Leadership Resources

While you continue your executive leadership job search, keep in mind that AMN Healthcare provides great support for our candidates. Begin the application process now, and then access the links below to learn how AMN Healthcare supports your advancement in healthcare.

  • Interim Executive Jobs: A great option for temporary, interim jobs while you continue your permanent job search (or if you simply want to explore what's out there) .
  • Permanent Executive Jobs: Great executive jobs in great locations. Full onboarding and support while you get up-to-speed in your new position.
  • EAP: Our interims gain access to a valuable set of Employee Assistance Program benefits.
  • Search All Leadership Jobs: Uncover new possibilities in your career by exploring both short and long-term options and permanent choices. 

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