What It Takes to Be a Leader in a Pharmaceutical Firm

Pharma Medicine Pill Capsule Pharmaceutical Industry 3d Illustration“Change fatigue” is a phrase that a report from the McKinsey Company uses to refer to leadership in the pharma industry. Indeed, even before the COVID-19 pandemic, pharma wrestled with globalization, the quest to reduce costs, regulatory issues, and efforts to add value while remaining customer-focused, among other challenges.

An overview of pharma-leader responsibilities includes aligning services with institutional goals, generating maximum revenue, collaborating with the leadership team to reduce costs, and managing technology investments. Senior pharma leadership teams may include such roles as Chief Medical Officer, Chief Ethics and Compliance Officer, Chief Quality Officer, Senior Director, Executive Director, Assistant/Associate Vice President, Vice President, and Therapeutic Head. Some emerging executive positions observed by Adam Millinger and his co-authors include Transformation Leaders, Ecosystem Leaders, and Enabling Leaders.

A comprehensive study of the career paths of 50 pharma CEOs by Nathaniel Brooks Horwitz reveals that the average age of pharm leaders is 58. Only three companies in his study are led by women, Horwitz points out.

The pharmaceutical industry, of course, has been particularly impacted by the COVID-19 pandemic. “The COVID-19 lockdown has exposed deep dependence of the global economy on various aspects of pharma and healthcare companies,” writes Sonny Iqbal and Niveditha Viswanathan of consulting firm Ego Zehnder. The authors cite an emerging need for leaders to make rapid decisions, as well as to trust decisions that come from decentralized sources. Leaders need to be agile, responsive, and resourceful at this time, Iqbal and Viswanathan note. For Dana M. Krueger and Saule Serikova, the concept of “purpose” is key to pharma leadership in the pandemic. “Across all the activities of pharma companies,” the authors write, “from their investments in product development to directly impact patients in need, to the research and supply alliances they are building, to the charitable donations they make – the COVID-19 crisis has reinforced the need for pharma leaders to commit to, communicate, and exemplify the purpose that is at the center of their strategies and organizations.”


Preferred Background: Education and Experience

Horwitz’s study provides valuable insight into the kind of backgrounds that propel pharma leaders to the top. Horwitz made the surprising discovery that 35 of the 50 CEOs he studied have no advanced scientific or medical degree. MBAs, he notes, are by far the most common advanced degrees. He describes the typical career path of the leaders he studied: “a college STEM degree, an MBA or entry-level job in sales or operations, followed by a couple decades of conventional upward mobility through management roles of increasing geographic and financial responsibility.”

The management roles typically included in the “upward mobility” Horwitz describes may be country manager or a director of a minor franchise, followed by head of sales for a region or head of development for a small division, VP of sales or operations or R&D, and then a promotion into a role as SVP, EVP or president of a continent or franchise, and finally the C-suite as either COO or CFO. “A few leap directly to CEO,” Horwitz says.


Desirable Characteristics

An array of hard skills, soft skills, and personal traits are keys to success in pharma leadership. In the white paper, The Leadership Challenge in the Pharmaceutical Sector: What Critical Capabilities are Missing in Leadership Talent and How Can They be Developed?, Jean Brittain Leslie and Kim Palmisano report that the ability to build collaborative relationships was identified as the most important skill. Additional characteristics from this and other studies include the following:

Predominant Leadership Styles in the Pharma Industry

Globally, leadership styles in the pharma industry have been extensively studied, with many scholars and experts arguing for a mix of leadership styles. In 2016, Partha S. Mukherjee, director of analytical development at Bristol-Myers Squibb, promoted the situational-leadership style, while also giving a nod to the transformational style, noting that “transformational leaders have integrity; they are excellent communicators, self-aware, empathic, lead with humility, take accountability, and they inspire by emotional intelligence.”

Experts also point to a trend in leadership styles oriented toward building relationships and leveraging teams. In a chapter in Value Creation in the Pharmaceutical Industry: The Critical Path to Innovation, Aubyn Howard observes that “the rapid rise of the Pluralistic–Social paradigm over the last 20 years has brought more collaborative styles of leadership which enabled the emergence of conventional forms of open innovation.”

Leadership style can be especially significant for women making their mark in the pharma industry. Barbara Morgan, an executive at Lubrizol Life Science Health, advises women to embrace various styles, noting that “highly extroverted and assertive leadership styles” manifest themselves differently in women than in men. “We have to be inclusive and open,” Morgan writes, “to allow female leaders to be authentic to themselves and not feel pressured to personify the accepted leadership style.”



Several excellent guides to leadership paths in the pharma industry are available:


What It Takes to Be a Leader in Healthcare

Because labor costs typically consume 50 to 60 percent of a hospital’s operating revenue, less-than-stellar leadership can have a significant impact. “Healthcare organizations represent a system of processes, people, and other resources that must be led effectively to achieve the desired outcome of high-quality, safe patient care,” writes Carol J. Huston, a nursing leader and nurse educator.

While healthcare leadership encompasses a number of diverse roles, the functions of healthcare leaders usually include planning and overseeing healthcare services in compliance with laws and regulations while striving to improve quality and efficiency, often with the assistance of new technologies. “Effective leadership,” notes the blog of Advent Health University, “has been positively associated with increased patient satisfaction and lower rates of adverse health results.”

Leadership roles in healthcare include population-health leader, patient-safety leader, patient-experience leader, change-management leader, staffing/scheduling leader, in addition to C-Suite positions like Chief Compliance Officer (CCO), Chief Executive Officer (CEO), Chief Financial Officer (CFO), Chief Operating Officer (COO), Chief Learning Officer (CLO), Chief Medical Information Officer (CMIO), Chief Medical Officer (CMO), Chief Nursing Officer (CNO), Clinical Department Manager, and Chief Quality Officer (CQO).

Arguably, the COVID-19 pandemic has affected healthcare more than any other industry and has required an adaptive leadership style. Writing for the New England Journal of Medicine’s Catalyst site, physician Kevin Lobdell and his co-authors assert that the healthcare system is not well structured to address a pandemic in an interconnected and interdependent world. “Prioritizing engaged leadership, and emphasizing a more team-oriented approach to care delivery and collaboration across institutions,” Lobdell et al write, “will improve systems in the short-term, and ultimately, set conditions for long-term change.”

The pandemic is not the only leadership challenge healthcare leaders face. Tim Flanagan of HealthCare Recruiters International also cites revenue outpaced by spending, increasing regulations, demand for new levels of quality and cost transparency, a surge in non-traditional competitors, expansion of population health, and rapidly changing technology.

Preferred Background: Education and Experience

Because leadership roles in healthcare are diverse, no typical path of education and experience exists, but for the top leadership role of hospital CEO, a Master of Health Administration or Hospital Administration degree is common, along with at least eight years’ experience in administrative, healthcare, and management positions, notes the University of Scranton’s page on executive-leadership strategies in the medical field.

Desirable Characteristics

An array of hard skills, soft skills, and personal traits are keys to success in healthcare leadership. Comprehensive resources on competencies in healthcare leadership include the Healthcare Leadership Alliance Competency Directory, downloadable as an Excel spreadsheet, Leadership Competencies for Health Services Managers from the American College of Healthcare Executives (ACHE), and the Health Leadership Competency Model from the National Center for Healthcare Leadership (NCHL). Additional leadership characteristics include the following:

healthcare leadership skills table

Predominant Leadership Styles in the Healthcare Industry

Researchers have found that simply deploying a leadership of any kind has a positive effect in healthcare. Danae Sfantou and co-authors write of their research, “Leadership styles were found to be strongly correlated with quality care and associated measures,” going on to document associations between individual styles and positive outcomes: “Transformational and resonant leadership styles are associated with lower patient mortality, while relational and task-oriented leadership are significantly related to higher patient satisfaction.” The researchers found increased patient satisfaction closely related to transformational, transactional, and collaborative leadership.

Bhagyashree Sudhakar Joshi studied 41 healthcare leaders, learning that they used 10 leadership styles (autocratic, democratic, bureaucratic, laissez faire, paternalistic, transactional, charismatic, transformational, visionary, and coaching) to some extent, with the majority adopting a democratic style. Joshi concluded that hospital leaders should adopt a mixed leadership style.

While many healthcare experts like Joshi argue for a mix of leadership styles, others promote one specific style as most appropriate for the healthcare field. Victor Trastek, Neil Hamilton, and Emily Niles make a case for Servant Leadership in an article for the Mayo Clinic. “Servant leadership [is] the best model for health care organizations because it focuses on the strength of the team, developing trust and serving the needs of patients,” the authors assert. Tony P. Ospina touts transformational leadership, noting that “transformational leadership is not a ‘cure all’ remedy for the current issues in healthcare, but it addresses many common challenges that are faced.” Similarly, scholars Alenka Žibert and Andrej Starc point out that “transformational leadership is often associated with greater efficiency and positive organizational results, and consequently achieves a higher success rate of change.”


These excellent guides to leadership paths in the healthcare industry are available:

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What It Takes to Be a Private Equity-Backed Company Leader

When businesspeople refer to private equity-backed company leaders, they are typically referring to CEOs hired by private-equity (PE) firms to run new acquisitions in their portfolios (these portfolio companies are sometimes abbreviated as “portcos”). PE firms may hire other leaders, such as CFOs and other C-suite executives, but CEOs are the main focus.

Much of the literature about private-equity backed CEOs emphasizes differences between the environment in which portco CEOs operate and that of CEOs of other companies. “Effective leadership in this space is very different from other types of ownership platforms,” writes John Myers, managing partner, Kensington International, noting “the acquisition of a company by a private equity firm is a seismic change for its leaders and employees.” Executive-search expert Chris Reinsvold points to a tight timeline with an anticipated ending since the PE firm’s goal is typically to eventually offload the portco at a profit. As private-equity search specialist Joe Hunt writes, “private equity is looking for CEOs who can drive and deliver performance in a defined timescale, optimizing the crystallization of value on exit.” Board interaction is different because often, “the majority of the board directors are principals in the private-equity firm,” Reinsvold says. CEOs in portcos invest their own funds in the portfolio company, with, Reinsvold says, “greater emphasis on the CEOs having enough ‘skin in the game.’” But, while the portco environment may be different from the environment at other companies, CEO skills and characteristics are not so different. Successful portfolio company CEOs are very similar to non–private equity CEO profiles, asserts What makes a great PE portfolio company CEO?, a report from Russell Reynolds Associates.

The same report shows portco CEOs offer a stronger skillset over other CEOs in certain areas, indicating superior skills among portco CEOs in juggling priorities, empowering others, exhibiting an even-keeled demeanor, and maintaining humility about their own achievements.

Private-equity-backed companies evince an emphasis on organizational culture, both in terms of performance and in terms of a CEO’s fit with the portfolio company’s culture. “The right corporate culture at a portco is essential for generating the business results required by the company’s PE sponsor,” states Alix Partners’s 2020 Fifth Annual Private Equity Leadership Survey, “and a portco’s culture depends to a great degree on who’s at the helm.” This emphasis on cultural fit is sometimes blamed for weak representation of women in portco CEO roles. “Humans tend to connect socially with those who share similarities to themselves,” notes an article from private-equity talent platform Falcon. A 2019 analysis by BoardEx of privately held US and UK businesses owned by PE and venture-capital firms showed that in the 12,221 companies studied, only 7 percent had female CEOs.


Preferred Background: Education and Experience

The aspect of a prospective portco CEO’s background considered most important for success is having had total P&L responsibility, the majority having held that responsibility as a general manager or CEO, states the Russell Reynolds Associates report, which also cites sales leadership and operational experience as key to “high growth and returns.” Relevant industry experience is also prized as a success factor, asserts the report, which goes on to state that prior portfolio company CEO experience “is actually not necessary.” Other studies claim the opposite, with a Harvard Business Review article noting that experience as a CEO in a publicly traded firm fails to prepare people for success in the intense PE environment. The literature on private-equity-backed CEOs is silent on education requirements, but job postings suggest master’s-degree-level training.


Desirable Characteristics: The Need for Speed

The trait most frequently cited for success of portco CEOs is speed of execution. Words and phrases such as “sense of urgency,” “warp-speed,” “agility,” and “quickness” are often mentioned with regard to this role. While hard skills take a back seat for portco CEOs, an array of additional soft skills and personal traits are keys to success in private-equity-backed leadership of portfolio companies:

Another frequently mentioned condition for success for the portco CEO is alignment with private-equity sponsors.


Predominant Leadership Styles in Private Equity

Rick DeRose of search firm Acertitude notes that “PE leaders must embrace a range of leadership styles,” which is another way of saying the primary leadership style for portco CEOs should be a situational approach. DeRose discusses a transformational style deployed by leaders who “thrive amid rapid change” and possess “the ability to persevere, even when overwhelmed and overloaded,” as opposed to a “maintenance” style characterized by feeling “most comfortable with the status quo.” DeRose suggests that “extreme transformers” are the key to a portfolio company’s exponential growth. The Russell Reynolds Associates report points out that CEOs who are too independent and lacking “regard for rules and processes” often don’t succeed.

The importance of leadership in helming a PE firm’s portfolio companies is timely in the age of COVID-19. “In private equity,” writes Marcus Beale, managing director at Drax, “leadership is a vital aspect of value creation. Leaders and their leadership teams, along with the culture and the environments they create, have the potential to deliver exceptional returns. Whether wartime or peacetime in leadership style, the Covid crisis’ effect on portfolio businesses has only amplified this fact.”



These reports shed additional light on success factors for those interested in the private-equity-backed company-leader role:

·       What makes a great PE portfolio company CEO?

·       Alix Partners’s 2020 Fifth Annual Private Equity Leadership Survey  

·       The Missing Ingredients: Three Things PE Investors Should Look for in a CEO

·       What It Takes to Lead: Challenges for the New Private Equity CEO


What It Takes to Be a Leader in a Private Equity Firm

Those who aspire to lead at the director level and above in the private-equity (PE) industry have no lack of opportunity. Private equity has been on a growth trajectory since the 1980s when very few PE firms existed compared to today’s $4 trillion global sector, according to a 2020 study by Prabhpal Grewal, Charles Hendren, Johan Öberg, Jonathan Croog, Markus Massi, and Maxim Khristenko of Boston Consulting Group (BCG). The authors speculate that “the industry’s success to date is a drop in the bucket compared with what the next ten years could hold.” Despite the growth, experts describe PE leadership roles as among the most competitive in finance and best suited to high achievers.

Top leadership roles in PE include Vice President, Director or Principal, and Managing Director or Partner. An emerging role is that of Leadership Capital Partner (LCP), estimated to be found in 80 percent of large private-equity firms, writes Dan Hawkins, founder and president of Summit Leadership Partners, who explains that the LCP oversees talent and organization performance of the firm’s portfolio companies. “Key attributes of the most impactful private-equity talent executives,” Hawkins notes, “include strong business acumen, a hands-on approach, functional expertise in talent, the ability to partner with company CEOs, and enough confidence and ego to work with investment partners as a peer.”

A consistent thread running through contemporary reporting and commentary on the PE sector is the need to increase diversity in PE firms, given consistent research that shows diverse teams outperform homogeneous teams. Experts note that diversity needs to include not just more ethnic and gender inclusiveness, but also greater varieties of leadership styles. A 2016 study by Financier Worldwide Magazine refers to “cookie cutter leadership teams.” Study authors Richard Thackray and Tom Thackeray, suggest “the bias (conscious or unconscious) that nudges leaders to hire and promote people ‘just like us’ remains strong.” The authors point to the risk that lack of diverse perspectives may result in sub-optimal investment decisions.

As PE firms increasingly recognize that diverse leadership means better performance, opportunity will open up for women leaders in the sector, who are currently in short supply. Just 5.2 percent of private-equity firm board seats are held by women, reports a survey by data provider Preqin. The study also shows women comprise less than 18 percent of private-equity employees globally and just under 10 percent of senior roles. A comprehensive 2019 study, “Moving Toward Gender Balance in Private Equity,” by the International Finance Corporation, reveals only 15 percent of senior investment teams are gender balanced, and nearly 70 percent are all male, despite the fact that “the performance of gender-balanced investment teams is correlated with higher returns.” Blogger Brian DeChesare compares PE firms to “frat houses.”

Preferred Background: Education and Experience

An MBA is valuable (in fact, getting hired right after an undergrad degree is rare), but two to five years of investment-banking experience before or concurrent with the MBA program is critical. While high academic achievement and prestige of the business school (think Harvard, Wharton, Insead, and Stanford) are low priorities to hiring managers in many fields, they are important in private equity.

Experience in investment banking is, by far, the top route to PE leadership, but strategy consulting and accounting can sometimes provide a foothold into the sector, according to the site Askivy, a recruitment and training platform. DeChesare, however, downplays the likelihood of breaking in from a non-investment-banking role, emphasizing that a background that includes transactions is key. He also emphasizes the importance of cultural fit with the PE firm.

Desirable Characteristics

An array of hard skills, soft skills, and personal traits are keys to success in private-equity leadership. DeChesare notes that the higher up the leadership chain an individual progresses, the more important soft skills are, especially skills associated with nurturing relationships.

In addition to the above, readers who seek an insider, “tell it like it is” view of the traits needed in the sector should check out DeChesare’s The Private Equity Career Path: The Complete Guide

Predominant Leadership Styles in Private Equity

As noted above, the PE sector comprises little diversity in leadership styles. The Financier Worldwide Magazine study of 51 managing partners, partners, and principals of European private equity firms revealed the majority of leaders gravitate to just two leadership styles, among the eight styles the study identified – collaborator, energizer, pilot, provider, harmonizer, forecaster, producer, and composer. Two-thirds fell into “forecaster” or “pilot” as their predominant leadership style. Study authors Tom Thackeray and Richard Thackray describe the forecaster style as “anticipatory,” focused on conceptual thinking, and possessing a depth and breadth of knowledge. Those with the pilot style offer strategic vision, the ability to manage complexity and build teams, along with a clear point of view.

Noting that both these styles come with blind spots, the authors also lament that “the least prevalent style is that of the ‘energizer’, a style characterized by the ability to build enthusiasm and inspire buy-in and engagement in others.”


Several excellent guides to careers and leadership paths in PE are available:

·       A Guide to Private Equity Careers

·       The Private Equity Career Path: The Complete Guide

·       How to Get Into Private Equity: Step-by-Step Guide

·       Career Guide to Private Equity Jobs

·       2020 Global Private Equity Survey (focuses on CFO role)

Outlook for the Chief Clinical Information Officer Role

What You Need to Know Right Now to Level Up as a CCIO

The role of Chief Clinical Information (or Informatics) Officer has its earliest roots half a century ago amid the emergence of Electronic Health Records (EHR), also known as Electronic Medical Records (EMR). For some organizations, the CCIO role is interchangeable with the Chief Medical Information/Informatics Officer (CMIO) role (and sometimes Chief Health Information/Informatics Officer), while in others, CCIOs work side-by-side with CMIOs, as well as with clinical informatics chiefs in multiple disciplines, such as nursing, pharmacy, and dentistry.

The role leads clinical informatics and is a “vital marriage of insight into clinical strategy and understanding of digital technology and systems,” Chloe Dobinson writes on the CIO site. Dobinson goes on to note that the role combines the clinical perspective with strategy, with an eye toward scoping out innovative technology for the organization.

The year 2016 was significant for the CCIO role as the American Medical Informatics Association (AMIA) released a report authored by Joseph Kannry and seven other researchers that was designed to define the highly heterogeneous role in terms of knowledge, education, skillsets, and operational scope. “Ensuring that the health system understands and incorporates effectively essential clinical HIT [Health Information Technology] requires the addition of the CCIO to the traditional CIO position,” Kannry et al state in the report.

Key Competencies for the CCIO Role

The CCIO role requires a bachelor’s or advanced degree in information technology, nursing, healthcare administration, or other related field. Many CCIOs climb the ladder from clinical backgrounds, including nursing, pharmacy, and dentistry, but as the AMIA report notes, “non-clinicians have very successfully executed this role.” Still, it’s not unusual for a CCIO candidate to be expected to bring at least five years of health-practitioner experience to the role, along with a background in clinical informatics and project management. Would-be CCIOs from non-clinical backgrounds must still possess insight and experience in healthcare settings, the AMIA report points out. CCIOs typically report to the Chief Information Officer (CIO).

When preparing career-marketing communications to send to employers, those aspiring to the CCIO role should emphasize these qualities:

  • Subject-matter knowledge of clinical informatics, health-information systems/applications, programming, hardware, and the healthcare system
  • Clinical decision-making skills
  • Clinical-care process improvement skills
  • Quality-improvement ability
  • Data analysis
  • Human-factors engineering
  • Ability to lead and manage change
  • Financial planning for clinical information systems
  • Strategic and collaborative decision-making
  • Grasp of the global healthcare context
  • Strong familiarity with and ability to analyze the clinical environment and clinical workflows
  • Up-to-date knowledge of health information systems and trends in the field
  • Commitment to protecting privacy and security
  • Problem-solving skills 

Level-Up Tips

Here are a few suggestions for those seeking to break into the CCIO role, expand their horizons in an existing CCIO role, or even rise beyond the CCIO role:

  • Demonstrate collaborative competencies. In an article on the site Healthcare Innovation, Rajiv Leventhal suggests that top clinical-information officers should closely align with Chief Information Officers, to whom they often report, also citing situations in which the lack of collaboration has been unworkable. Collaboration with the CIO, CMIO (if applicable), and IT teams to deliver efficient, cost-effective and adaptable technology products aims at “improving the patient journey and overall healthcare,” Dobinson notes. Similarly, in an interview conducted by Mark Hagland, George Reynolds, M.D., CIO, and CMIO of Children’s Hospital Medical Center in Omaha, suggests candidates “should know how to develop a team, build consensus, and establish relationships of trust.”
  • Obtain a board certification and join professional organizations. Hilary Ross, one of the executives Levanthal profiles in his article, suggests that high-level clinical informaticists “continue to add to their expertise by looking at analytics through a board certification of informatics, as well as joining organizations such as the American Medical Informatics Association (AMIA) and the Association of Medical Directors of Information Systems (AMDIS), where candidates can take advantage of their educational committees.” 
  • Know cutting-edge technologies. As in most areas of business, artificial intelligence (AI) and machine learning have grown increasingly important in healthcare informatics, so knowledge of these emerging technologies is an advantage. Writing for Becker’s Hospital Review, Diane Nole observes, AI’s “value will be in augmenting clinicians and optimizing their time.” Expertise in robotics, 3D bioprinting, nanomedicine, cloud computing can also boost CCIO marketability. A detailed infographic from the site Health Informatics describes how these technologies are used in healthcare. 
  • Adopt a patient-centered perspective. In describing their vision for a technology-based system in healthcare, Keith Horvath and his 10 co-authors observe that “patients and clinicians desire technology that facilitates access to and use of health information and communication tools leading to quality, person-centered care.” Prospective CCIOs with the will and creativity to promote through informatics what the authors describe ­– a reduced administrative burden, enhanced clinical care, and knowledge-sharing capabilities that benefit the patient – may be poised to make their mark in clinical-informatics leadership.
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Outlook for the Chief Nursing Officer Role

What You Need to Know Right Now to Level Up as a CNO

The Chief Nursing Officer (sometimes known as Chief Nursing Executive) is the top-ranking nursing management professional in any healthcare organization. A July 2017 study of CNOs by AMN Healthcare and The Center for the Advancement of Healthcare Professionals identified about 3,800 CNOs in the United States. The study found these CNOs spent most of their time on culture and operations. Approximately 68 percent of them report directly to the CEO; 91 percent are part of a senior-management team.

The CNO role has evolved from a focus primarily on hospital-based patient care to one much more tied to the organization’s success and results. “When I first graduated from college,” recalls CNO Carol Boston-Fleischhauer in an interview by Thomas Seay, “nurse executives were called ‘nursing directors’ and were typically focused on ensuring that inpatient nursing care was compassionate, safe, and effective – period.” Today, however, Boston-Fleischhauer notes, “organizations recognize that nursing is core to the strategic achievement of outcomes, including clinical, financial, growth/market share, and the like.” To attain those outcomes, she observes that CNOs collaborate directly with the chiefs of medicine, finance, strategy, IT, and quality, “to drive achievement of strategic as well as operational goals.” A respondent to the AMN Healthcare study similarly summarized the role’s evolution “from just staffing the nurse department to being a key player in setting and achieving organizational goals and decision-making for major changes.”

The role’s scope now extends far beyond the healthcare facility. “The CNO role now spans the entire care continuum, from telehealth and community-based care to home health and more, says Lamont M. Yoder, in an interview in Nurse Leader by Heather O’Sullivan. Blogger Pat Magrath calls CNOs consummate problem-solvers, noting that the CNO “balances passion for patient welfare with administrative management.”

Key Competencies for the CNO Role

The CNO role requires at least a Bachelor of Science in Nursing, and often a Master of Science in Nursing (with a suggested concentration in Nursing Administration or Leadership in Health Care Systems, or a dual degree in which the MSN is paired with a Master of Health Administration) or a doctorate in nursing (Doctor of Nursing Practice). Another master’s option is a Master of Business Administration (MBA) or Dual MSN/MBA. Licensure, of course, is a must, with nurses obtaining a state license as a registered nurse by passing the NCLEX-RN from the National Council of State Boards of Nursing.

Additional certifications also are available, including the Nurse Executive certification (NE-BC) through the American Nurses Credentialing Center (ANCC), certifications in Executive Nursing Practice and Management and Leadership (CNML) from the American Organization for Nursing Leadership (AONL), and Certified in Executive Nursing Practice Certification (CENP), also from AONL. The American College of Healthcare Executives (ACHE) also offers a credential, Fellow of the American College of Healthcare Executives.

A nursing career path leading to CNO includes gaining at least five years of increasingly responsible clinical roles that include management.

“As any nurse manager on the executive track will tell you,” exhorts Jackie Larson, senior vice president of a healthcare recruiting firm, “their performance on the job requires skills and aptitude well beyond their training as nurses.” When preparing career-marketing communications to send to employers, those aspiring to the CNO role should emphasize these qualities:

  • Passion for performance-driven, high-level leadership
  • Patient-care champion, focused on patient-care service and best quality and safety practices
  • Strong advocacy abilities to serve as spokesperson for nursing staff
  • Problem-solver
  • Keen business sense
  • Ability to foster a collaborative and strategic environment
  • Expertise in regulatory and compliance approvals and accreditations
  • Ability to partner with physicians as well as cultivate relationships across functions and departments
  • Change champion

In an article directed at those hiring a Chief Nursing Officer, these competencies and qualities were cited: an eye for detail, current clinical skills, critical-thinking skills, proactive approach to staffing, knowledge of when to lead and when to manage, business acumen, a “data junkie” approach, goal-setting behavior, as well as both knowledge of the big picture and the ability to communicate the bigger picture. The 2017 AMN Healthcare study identified five crucial evolving competencies for nurse leaders: influencing innovation, spanning boundaries, collaboration, expanding the accessibility and use of technology, and courage

Level-Up Tips

Here are a few suggestions for those seeking to break into the CNO role, expand their horizons in an existing CNO role, or even rise beyond the CNO role:

  • Boost your expertise on the business side. Experts have identified lack of business acumen as an area for improvement for CNOs. “Even if they have completed BSN or MSN degrees,” Larson notes, “the curriculum they have completed typically does not contain enough, if any, of the business training they will need to perform and advance their careers. The bulk of that learning, at least initially, is done on the job and/or through a mentor.” In her 2015 research Charlene Ingwell-Spolan noted that nurse executives “are unprepared to fully communicate in financial, business terms.” Instead, Ingwell-Spolan points out, “clinical decisions in the health care business are often made by the financial and business executives without full and adequate input from the CNO.”

A list of advice tips for CNOs that Anuja Vaidya collected for Becker’s Hospital Review features these cautionary words from Kathleen Sanford, RN, Chief Nursing Officer of CommonSpirit Health in Chicago: “Looking back over a lengthy career, the one piece of advice I would give my younger self is this: Get as much management and leadership education and knowledge as possible, as early as possible.” Other experts advise reading as many books as possible on executive management and leadership, as well as sharpening strategic skills. “Today’s CNO,” Larson asserts, “must be as comfortable talking about methods to improve productivity and reporting and the strategic importance (or lack thereof) of an IT initiative as they are about patient care initiatives.”

  • Advocate for your nursing staff. “Nursing is the largest, most trusted workforce in all of health care and a critical asset to leverage,” points out Boston-Fleischhauer. Serving as the voice for the nursing workforce is seen as a way for nurse leaders to get ahead. “The key to moving forward is having strong nurse leaders who are willing to advocate for nursing in the C-suite,” says Katie Boston-Leary, chief nursing officer at University of Maryland Prince George’s Hospital Center. 
  • Join or create a peer-support group. That’s the advice of Shane Parker, a nurse who founded a hospital-scheduling software form. The group could be local or could encompass nurse leaders all over if it’s virtual. Parker suggests the group discuss practical and theoretical leadership concepts. Even without a group structure, Parker points out, CNOs can informally seek advice and support from their counterparts by phone or email. “No matter how you construct your support group,” Parker says, “you’ll benefit from interacting regularly with those who have ‘been there, done that.’” 
  • Gain varied experience by serving as an interim CNO. The 2017 AMN Healthcare study reported that “many organizations turn to interim management as a proven way to bridge leadership transitions;” in fact, 50% percent of nurse executives have utilized interim leadership services. Serving in interim role provides the opportunity for CNOs to gain diverse experience.

 CNO Trends to Watch 

  • Millennials are prevalent in the nursing workforce. About 50 percent of nurses today are of millennial age. One CNO goes so far as to have taken on a millennial nurse mentor so she can understand this demographic. “I think it’s important to stay on top of the issues of the nurses coming in and managing the different generations, [and] to be able to provide opportunities for growth, preceptorship, and communication methods,” states Karen Clements, CNO at New Hampshire-based Dartmouth-Hitchcock.
  • Patient and consumer engagement come to the forefront. For the past several years, healthcare systems have been encouraged to engage with patients even when they’re well, Shane Parker observes. Consequently, former CNO Davy Crocket suggests that CNOs “be the Chief Patient Engagement Officer whether you have the title or not. Have a philosophy that the patient and family is always right, even when they are not. You may be the clinical expert, but they know what matters most to them. Engaging patients in their care leads to better outcomes.”
  • CNOs are well positioned to be change agents. Crockett also believes CNOs “must become masters of managing organizational change to guide their healthcare system through the constant flux of innovation and disruption.” He advises CNOs to study change-management techniques and be aware that a CNO’s ability to manage change in 2020 and beyond “plays a pivotal role in how well your organization performs in the marketplace.”
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Outlook for Chief Telehealth Officer Role

What You Need to Know Right Now to Level Up as a CTO

Of all C-Suite roles, the Chief Telehealth Officer (CTO) role is arguably the most affected by the 2020 Covid-19 pandemic and is thus likely to present growth opportunities.

The Chief Telehealth Officer role is sometimes identical or similar to roles with such titles as CEO for Telemedicine, Chief Health Information Officer, and Chief Healthcare Technology Officer, the latter two of which may encompass telehealth along with other aspects of health technology. At companies whose sole focus is telehealth, the CEO role becomes synonymous with Chief Telehealth Officer.

In what CNBC’s Bertha Coombs calls “a massive expansion” from pre-pandemic telemedicine usage, virtual health-care interactions were predicted to top 1 billion by the end of 2020, aided in part by government expansion of Medicare reimbursement for telehealth as part of its stimulus package. In a study by Clearlink, a marketing company focused on customer experience, almost 75 percent of respondents said they’d consider using telehealth to be remotely screened for COVID-19, with two-thirds agreeing the pandemic has increased their willingness to try virtual care.

Even before the pandemic, however, telehealth was on an upward trajectory; in 2019 Lyle Berkowitz, MD, Chief Medical Officer for MDLive, attributed growth to “consumer demand, reimbursement alignment, and an improved regulatory environment.” Reduced costs, potential to generate patient satisfaction, and the quest for quality also contribute to telehealth’s growth. Virtual care is seen as a way to help prevent caregiver burnout.

Strong leadership and telehealth governance are seen as keys to growth by Telehealth and Medicine Today researchers Bryan Arkwright, Jeff Jones, Thomas Osborne, Guy Glorioso, and John Russo, Jr., who assert from an implementation perspective, the “telehealth executive champion” and the “telehealth leader” play important roles.

Key Competencies for the CTO Role

The Telehealth and Medicine Today researchers identified four sources for “telehealth executive champion” hires: Internal candidates with experience in telehealth planning or operational implementation, internal candidates with backgrounds in business development and leading clinical operations, telehealth-experienced external hires who have started and led a “matrix-aligned telehealth program,” and interim leaders from organizations open to all viable and established solutions, as well as experience starting and leading a matrix-aligned telehealth program.

Typically, an MD degree is required for the CTO role.

When preparing career-marketing communications to send to employers, those aspiring to the CTO role should emphasize these qualities:

  • Ability to recruit physicians and allied-health professionals to the telehealth program.
  • Vision for the organization’s clinical direction.
  • Knowledge of emerging models in healthcare delivery.
  • Healthcare leadership experience.
  • Innovative drive to achieve business goals and objectives.
  • Collaborative abilities to build partnerships with other health-delivery systems to achieve affordable outcomes.
  • Strategic approach.
  • Telehealth policy-making skill.

Level-Up Tips

Here are a few suggestions for those seeking to break into the CTO role, expand their horizons in an existing CTO role, or even rise beyond the CTO role:

  • The riches may be in the niches. Specialization provides additional growth into such areas as telepediatrics, teleradiology, telepathology, telecardiology, teledermatology, telepsychiatry, and many more. Provider-to-Provider telehealth is another niche area.
  • You may not need a healthcare background. Citing high demand for healthcare technology talent, healthcare recruiter Bonnie Siegel, notes that IT professionals from other industries are sometimes sought for executive telehealth roles; however, relaxation of the MD requirement is more common for Chief Healthcare Technology Officers than for Chief Telehealth Officers.
  • Growth provides opportunities for women. MedCity News’s Christina Hernandez Sherwood cites Julie Hall-Barrow, vice president for virtual health and innovation at Children’s Health, Dallas, for her observation that “the number and variety of jobs in telehealth have created new opportunities for women across business, clinical, and technology sectors. The value of women in health IT leadership roles is evident, resulting in increased numbers of women holding senior leadership roles in telehealth, health systems, and health IT in general.”
  • Expertise in artificial intelligence (AI) is an increasingly important asset. Recognition of AI and machine learning as valuable tools in telehealth is on the rise. Those well-versed in these technologies will likely be seen as attractive CTO candidates.

 CTO Trends to Watch

  • More and more physicians are adopting telehealth. Physician adoption of telehealth increased 340 percent from 2015 to 2018, notes American Well’s Telehealth Index 2019 Physician-Survey, with almost 70 percent of respondents who hadn’t yet adopted indicating a willingness to try telehealth. Physician adoption is yet another growth indicator that bodes well for prospective CTOs.
  • Telehealth training is expanding. Medical and nursing schools are integrating telehealth into their programs, notes Todd Czartoski, MD, Chief Executive Telehealth, Providence St. Joseph Health. Aspiring CTOs will have greater opportunities to build early-career expertise.
  • Growth is also expected on the patient side. In a survey cited on the blog of General Devices, 74 percent of respondents said they are willing to use telehealth services, while 76 percent of patients surveyed said they find access to healthcare more important than in-person appointments. It is not unreasonable to speculate that these numbers will skyrocket as more and more patients have no choice but to use telehealth during the COVID-19 pandemic, and ideally have a positive experience.
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Outlook for the Chief Medical Officer Role

What You Need to Know Right Now to Level Up as a CMO

The watchwords for the role of Chief Medical Officer (CMO) are “change” and “evolution.” No longer solely focused on patients in hospitals, CMOs are now often charged with leading sweeping transformation. Martha Sonnenberg, MD, suggests numerous new competencies required of CMOs, including integrating hospital utilization, quality and safety, credentialing, and physician practice evaluation, as well as heading off conflicts between physician goals and hospital goals.

Roles similar to and sometimes overlapping with the CMO role include Chief Quality and Safety Officer, Chief Integration Officer, Chief Physician Executive, and Service Line Medical Director. Writing for Managed Care magazine, Timothy Kelley suggests that “Chief Clinical Officer” is a more attractive and accurate title for the role because it embraces “care management, population health, quality reporting, and strategic planning.”

Where virtually all CMOs were once hospital-based, Chief Medical Officers today function in three basic environments:

·       Hospitals and similar medical facilities, where they manage clinical operations, ensuring patient safety and quality medical care by influencing and coordinating administration and medical staff.

·       Pharmaceutical firms, in which, writes David Shaywitz for Forbes, they function in one of three roles: (1) overseeing all drug development, along with such activities as medical affairs; (2) leading medical functions but not drug development; or (3) serving as strategically focused “medical counselor in chief” with no responsibility either for product development or medical functions. McKinsey’s Edd Fleming, Ken Park, Nav Singh, and Ann Westra prescribe “fundamental changes” to the pharma CMO role designed to result in “a single point of accountability” who can drive organizational change.

·       Large tech companies at what Shaywitz calls the “intersection of technology and health,” serving as “an authoritative voice to represent healthcare inside the company, as well a credible voice to represent the company to the external healthcare community.”

Key Competencies for the CMO Role

The CMO role requires a medical degree and state licensure as a physician, sometimes enhanced by specialty-practice certifications and a degree in business, as well as management experience and 5-10 years of clinical experience beyond residency. CMOs typically report to the Chief Executive Officer or board of directors, though more than half have multiple or shared administrative reporting relationships, notes Becker’s Hospital Review.

When preparing career-marketing communications to send to employers, those aspiring to the CMO role should emphasize these qualities:

  • Grasp of IT and analytics
  • Business, marketing, and legal knowledge
  • Ability to manage culture change
  • Exceptional interpersonal skills to recruit, engage, mentor, and align physicians, as well as liaise between administration and medical staff
  • Clinical risk-management skills
  • Exemplary written and verbal communication skills
  • Advocacy for the highest standard of medical care for patients
  • Ability to inspire physician performance
  • Expertise in healthcare regulations and safety standards
  • Innovation skills to improve clinical services
  • Budgeting skills
  • Effective leadership and management skills
  • Vision and ability to set goals

Level-Up Tips

Here are a few suggestions for those seeking to break into the CMO role, expand their horizons in an existing CMO role, or even rise beyond the CMO role:

  • Consider a supplemental degree. Though medical school is a huge commitment, prospective CMOs can make themselves even more marketable with a Master of Health Administration (MHA), Master of Public Health (MPH), or Master of Business Administration (MBA).
  • Lighten the current CMO’s load. On the Becker’s Hospital Review site, Laura Dyrda reports on survey results in which 86 percent of surveyed CMOs cited a desire to “offload responsibilities to other leaders, most likely medical staff tasks,” so they can focus on their top priorities. If you are not yet a CMO, boost your learning and visibility by asking what you can do to assist.
  • Turn to artificial intelligence and machine learning. These days, nearly every executive role is advised to deploy these emerging technologies. “Technology can help support clinicians and researchers by analyzing massive amounts of information, machine reading, and applying learning heuristics that support the decision-making process,” says Microsoft’s David Rhew, as quoted by Bill Siwicki in Healthcare IT News.
  • Become adept with clinical strategy. When Manoj Pawar talked with CEOs to identify what these top officers want to see in the CMOs who report to them, he learned that CEOs have “an increasing desire for closer collaboration between the CMO and the Chief Strategy Officer,” which may involve “identifying potential new partners, managing external relationships, managing key external groups for engagement and performance, and creating new venues for participative management around value.” CEOs also told Pawar they are looking for CMOs to lead collaboration around clinically relevant cost management and manage the clinical value proposition.
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Outlook for the Chief Administrative Officer Role

What You Need to Know Right Now to Level Up as a CAO

The C-Suite’s closest cousin to the Chief Administrative Officer (CAO) is the Chief Operating Officer, and indeed, the titles are sometimes used interchangeably. A common role for the CAO is to serve as an intermediary between the Chief Executive Officer (CEO) and department heads, overseeing functions such as finance, sales, human resources, and marketing. The Chief Administrative Officer monitors departmental performance and reports back to the CEO.

One motivation for hiring a CAO is the underperformance of one or more departments. The CAO in that scenario will likely get involved in setting success metrics, analyzing progress toward goals, and keeping the CEO up to speed with the department’s quest for success. The CAO will also often collaborate with departments that lack a C-Suite presence. Because of their intricate departmental knowledge, CAOs are C-Suite influencers with insider expertise.

In a case study about bringing on a CAO, executive-search firm Helbing & Associates, Inc., shared its client’s motivation for hiring this role: “[A] multi-billion dollar contractor, and longstanding partner of Helbling, sought to secure a Chief Administrative Officer who would provide additional depth to their C-suite, create a unified corporate service culture, and develop a long-term operational strategy.” The client company sought to collapse six corporate service areas – human resources, information technology, safety, risk management, legal, and compliance – into a single unit, thus “creating the Chief Administrative Officer (CAO) role [that] would provide structural relief to the CEO’s reporting structure and allow a new leader to dedicate themselves full-time to those six areas.” The selected candidate had been a Chief Operating Officer of a similar firm who offered the client’s desired “combination of operational, strategic leadership, profit/loss management, and corporate service experience and knowledge.”

The case study noted that talent pool was shallow for the CAO role. Aon Hewitt reports that, across all industries, just 20 percent of businesses have a CAO role. Insurance firms are the most likely (35 percent) to have CAOs, with the retail and financial sectors following, and the manufacturing sector having the fewest CAOs. Other industries include physician practices, law firms, universities, and municipal agencies.

Key Competencies for the CAO Role

The CAO role requires a synthesis of analytics, process, and strategy. A bachelor’s degree is the basic educational requirement; an MBA is an extra selling point.

When preparing career-marketing communications to send to employers, those aspiring to the CAO role should emphasize these qualities:

  • Solid managerial experience
  • Working knowledge of government businesses regulations
  • Excellent written, interpersonal, and verbal communication skills, including facility with briefing CEO on departmental progress
  • Strong leadership and team working abilities
  • Decision-making skills
  • On-time/on-budget project management.
  • Ability to deliver instructional leadership to department managers
  • Ability to contribute to developing and implementing strategic plan
  • Administrative policy-making; evaluating and updating company policies as needed
  • Budget planning and development
  • Ability to establish success metrics and analyzing department data against goals

Level-Up Tips

Here are a few suggestions for those seeking to break into the CAO role, expand their horizons in an existing CAO role, or even rise beyond the CAO role:

  • Be sure the CEO is involved in hiring. If you’re under consideration for a CAO role, ask about how you will interact with the CEO. Rapport between CEO and CAO is important. “Because of the great deal of collaboration that will likely happen between the CEO and the CAO,” reports Study.com, “the CEO should always be on board when a CAO is chosen for the company.”
  • You could be next. “CAO is considered one of the key stepping stones to the CEO position,” notes Alicia Betz. Since the CAO is often the CEO’s right-hand person, this succession scheme is natural in some organizations.
  • Demonstrate your ability to make high-level/high-complexity decisions. Fast Company’s Jared Lindzon notes that CEOs are increasingly delegating tasks to their C-Suite executives, and “chief administrative officers will help relieve CEOs and COOs of some of their day-to-day tasks, allowing them to put their time and effort towards critical, big-picture decisions.”
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Outlook for the Chief Legal Officer Role

What You Need to Know Right Now to Level Up as a Chief Legal Officer

What’s the difference between a Chief Legal Officer (CLO) and a General Counsel (GC)? The primary difference is that most Chief Legal Officers report directly to the CEO while a General Counsel does not. While not all CLOs report to the CEO, however, in Fortune 500 companies, 93 percent of Chief Legal Officers have a direct reporting line to the CEO. CLO is the newer and more contemporary title of the two. In Europe, the CLO often serves as an advisor to the executive committee instead of being part of the C-Suite, notes Piet Hein Meeter, global managing director of Deloitte Legal, Deloitte Touche Tohmatsu Limited.

Frequently a publicly traded company’s most powerful legal executive, the (CLO) is a leader whose expertise helps an organization minimize its legal risks by advising officers and board members on significant legal and regulatory issues the company faces, such as litigation risks. Up until recently, this mandate has been roughly the same for both GCs and CLOs.

But the roles are diverging. As Steve Feyer notes on the blog of Apttus, a firm that helps companies modernize their revenue and legal operations, “the GC may concern himself or herself only with the legal matters of the organization, while the CLO is concerned with connecting those legal matters to the broader objectives of the organization.”

Indeed, recent research shows that CLOs highly value being well positioned to influence corporate strategy. The 2019 ACC Chief Legal Officers Survey reported that …

  • CLOs who report to the CEO are more often sought for their input on business decisions than those who do not.
  • CLOs who report to the CEO are more likely to frequently attend board meetings.
  • CLOs have a strong track record in leading compliance efforts, as noted later in this article.

A real-life illustration about how this wholistic approach can play out can be seen in an interview with Ritu Vig, Chief Legal Officer at SP+, who reveals this turning point in her corporate-law career: “Ultimately, I realized what I am passionate about is using the legal function to drive growth in a business. The traditional mindset is that the law department is a cost center to mitigate risk. But it’s a lot more than that, and there’s an opportunity to understand the business in a unique way.”

In an attempt to clarify the difference between the CLO and GC roles, the Association of Corporate Counsel gathered opinions from members of its subgroups. Echoing the emphasis on strategy throughout the whole organization, one respondent said, “the CLO title signals a focus on the role of the legal department’s top lawyer to lead a team or set a tone that focuses on providing business solutions to problems, rather than just legal analysis.” Another respondent speculated that the Chief Legal Officer title is especially used in companies that are subject to regulatory language that specifically mentions “Chief Legal Officer.”

A Deloitte report, The four faces of the chief legal officer, identifies the Chief Legal Officer’s role as Catalyst, Strategist, Guardian, and Operator. Ken Avery, director of Deloitte’s CLO Program, describes today’s CLO as “more than accomplished attorneys; they have a broad view of the business, industry, and company strategy, and manage a staff of senior attorneys that is expected to take that same broad view.”

Key Competencies for the Chief Legal Officer Role

The CLO role typically requires a law degree, obtained after earning a bachelor’s degree in business law or pre-law studies. Undergrad coursework recommendations to prepare today’s CLO from the site Legal Career Path include cyber law, international law, argumentation theory, public speaking, communication courses, communication law, symbolic logic, and an introductory course to legal practice. The site also suggests pursuing internships during undergraduate coursework to gain experience in the field.

Once in law school, the best focus area for the CLO path is corporate law; Legal Career Path advises courses in intellectual property law, corporate governance, corporate finance, public company disclosure, corporate professional responsibility, and advanced corporate transactions.

In your career-marketing communications, showcase the Chief Legal Officer competencies and characteristics on this list you possess:

  • Effective verbal and written communication
  • Exceptional leadership skills
  • Analytical skills
  • Exemplary negotiation skills
  • Problem-solving skill
  • Advocacy aptitude and experience
  • Business acumen
  • Corporate governance expertise
  • Crisis-management ability
  • Integrity and sound ethics
  • Management skills (including coordinating internal and external resources)

Level-Up Tips

Here are a few suggestions for those seeking to break into the Chief Legal Officer role, expand their horizons in an existing Chief Legal Officer role, or even rise beyond the Chief Legal Officer role:

  • Emphasize the compliance track record for CLOs: The 2019 ACC Chief Legal Officers Survey cites a study that found that companies whose CLOs are among the top five compensated officers have a 50 percent reduction in compliance failures compared with companies where CLOs were not among the top five compensated officers.
  • Connect metrics to key corporate objectives. On trend with the concept of CLO as whole-organization strategists, CLOs are advised to use metrics to tout their team’s performance.
  • Go for the “hot” areas. Areas of corporate law that are especially in demand and could position you well as a CLO include privacy, compliance, and regulatory affairs. “Chief legal officers are become increasingly valuable to companies throughout the world amid growing concerns about new regulations,” says the 2019 Association of Corporate Counsel CLO Survey. Of issues most likely to influence company decisions, CLO survey respondents cited regulation more than any other issue. Beefing up technology skills can’t hurt either. “Lawyers have a reputation for being technology-averse,” notes the writer of the Apttus blog, “but this often is not true – and it certainly should not be true for a CLO. Embrace all the value-added technologies available to you and promote the positive effect they have on your organization.”
  • Take the initiative. In a Deloitte report entitled “Own your space: Leadership advice from a trailblazing Chief Legal Officer,” retired CLO Susan Blount advises going beyond the requirements of one’s job to the point of “anticipating questions, adjusting strategies, and identifying opportunities for cost savings and client education without being asked.” This process of “owning your space,” as Blount calls it, shows that the “rising leader is adding value to his or her organization beyond technical legal skills and is personally taking charge of his or her career.”

Chief Legal Officer Trends to Watch

  • CLOs are being asked to do more with less. “Legal departments are being asked by the business to become more global, counsel leadership about new developments, and be more transparent about the value they deliver to the organization,” Deloitte’s Meeter asserts, noting that the departments are simultaneously mandated to be more efficient and reduce costs.
  • Not just cost-saving, but revenue-producing. Deloitte’s Avery observes that CLOs are finding their departments are not just being asked to reduce costs, “but in some sectors, legal departments are expected to be more than a cost center.” Avery points, for example, to monetization of intellectual property “to generate revenue and contribute to an organization’s overall financial results.”
  • Sustainability is an emerging area of concern for CLOs. CLOs and their teams are playing increasingly significant roles in sustainability – and even leading sustainability efforts, reports the 2019 ACC Chief Legal Officers Survey. “CLOs outpace the CFO and chief operating officer (COO) when it comes to direct oversight of sustainability teams or individuals,” the report states.
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