Hiring a Healthcare Executive? Start With the Problem They Actually Need to Solve
Healthcare organizations often begin an executive search by focusing on the title and the experience they think should come with it. CEO. COO. VP of Operations. Executive Director. But before building the job description or deciding what the ideal resume should look like, there’s a more important question to answer: What does this leader actually need to fix, build, or lead?
Having worked on both sides of healthcare hiring, first as an operator responsible for teams and performance and later in healthcare recruitment, I’ve seen how easy it is to focus on finding the right candidate before getting clear on what the organization really needs from the role. And at the executive level, that distinction matters.
Maybe the organization is growing faster than its operations can support. Maybe performance has stalled, turnover is becoming a problem, or a leadership transition has exposed issues that have been building for years. The right executive for each of those situations may look very different, even if the title on the job description is exactly the same.
Before you start searching for the person, get clear on the problem you need that person to solve.
Before You Search, Define the Real Leadership Need
One of the easiest mistakes to make in executive hiring is starting with the person who left.
If your COO resigns, the natural reaction is to look for another COO with a similar background. If an Executive Director position opens, you pull out the old job description, update a few lines and start recruiting.
But leadership transitions are also an opportunity to ask whether the organization needs the same thing it needed three or five years ago.
What is happening in the business today? Are you expanding locations or service lines? Struggling with turnover? Trying to improve financial performance? Managing rapid provider growth? Dealing with inconsistent processes across sites? Preparing for a major operational change?
Those answers should shape the search.
A healthcare executive who is exceptional at stabilizing an established operation may not be the right person to lead aggressive growth. Someone who has successfully opened new markets may not be the leader you need to rebuild a struggling culture. And a candidate with experience at a large health system may not automatically translate to a smaller organization where the executive is expected to stay much closer to day-to-day operations.
The goal isn't to build the longest list of qualifications. It's to identify the experience and leadership capabilities that actually match what the organization needs next.
Define What Success Looks Like Before You Write the Job Description
A job description can tell a candidate what they’ll be responsible for. It doesn’t necessarily tell them what they’re walking into.
Before deciding what experience, education, or credentials belong in the posting, define what you need this leader to accomplish in the first 6 to 12 months.
For one organization, success might mean stabilizing a team that has experienced significant turnover. For another, it could mean improving margins, integrating newly acquired locations, rebuilding provider relationships, standardizing operations across multiple sites, or creating better visibility into performance.
Those priorities should influence who you recruit and how you evaluate them.
This is also where getting specific about how success will be measured matters. If you expect a new executive to improve retention, increase access, reduce costs, strengthen provider productivity, or improve operational performance, determine what those measures look like before the person walks through the door.
Otherwise, it becomes very easy to hire someone who looks right on paper without ever defining what “right” actually means for the organization.
Hire for the Challenge, Not Just the Resume
Healthcare executive searches can become overly focused on finding someone whose resume looks exactly like the person who held the role before them.
Same type of organization. Same specialty. Same title. Similar number of years in leadership.
Some of those requirements may absolutely matter. But when every qualification becomes non-negotiable, organizations can unintentionally screen out leaders who have already solved the exact problems they are facing.
A candidate may not have spent the last ten years in an identical organization, but they may have successfully integrated multiple locations, rebuilt an underperforming team, improved provider access, led through an acquisition, strengthened financial performance, or created operational structure during rapid growth.
That experience can be far more valuable than simply checking every box on a traditional executive job description.
The question shouldn't only be, “Has this person held this exact role before?”
It should also be, “Have they successfully led through what we're about to ask them to lead through?”
That shift opens the search without lowering the standard. In many cases, it actually makes the standard more relevant.
Interview for the Work They’ll Actually Be Doing
Executive interviews can easily become conversations between accomplished people who are all very good at interviewing. At this level, that isn't enough.
If you've already identified what the new leader needs to accomplish, use those same priorities to shape the interview.
Instead of asking only broad questions about leadership style or past accomplishments, give candidates situations that reflect what they may actually inherit. If the organization is struggling with turnover, ask how they would approach their first 90 days with the team. If multiple locations are operating differently, ask how they would determine what should be standardized and what shouldn't. If performance is slipping, ask what information they would want to see before deciding where to intervene.
Then listen to how they think, not just whether they arrive at the answer you expected.
Strong executive candidates should be able to ask good questions, identify what they don't yet know, balance competing priorities and explain how they would move from understanding the problem to taking action.
The interview should give you a glimpse of the leader at work, not simply confirm that they know how to interview well.
The Search Doesn't End When the Offer Is Signed
Hiring the right executive is only part of the equation. The organization also has to create the conditions for that leader to succeed.
If you recruited someone to solve a specific problem, make sure they actually have the authority, information and support to address it. A new executive shouldn't spend the first several months discovering that the priorities discussed during the interview aren't actually the priorities of the board, CEO or leadership team.
This is where the work you did before the search becomes valuable again.
Revisit the outcomes you defined. Establish what should happen in the first 30, 60 and 90 days. Make sure the new leader understands where decisions can be made independently, where alignment is required and which stakeholders will be critical to moving the work forward.
And don't wait until an annual review to find out whether expectations were different on each side.
The strongest executive hire can still struggle in an organization where the mandate is unclear, information is difficult to access or the authority doesn't match the accountability.
Recruitment gets the leader in the door. Alignment gives them a real opportunity to succeed.
Getting the Executive Hire Right
Executive hiring carries a different level of consequence. The wrong hire can affect far more than one department, and the right one can change the trajectory of an organization.
That's why the strongest executive searches don't begin with a list of qualifications. They begin with clarity about what the organization needs next, what the leader will be expected to accomplish, and what kind of experience will prepare someone to take that on.
At Med Match Solutions, we bring both healthcare operations and recruiting experience to executive search. We understand the realities behind the role because we've worked inside healthcare organizations where leadership decisions affect teams, providers, performance and ultimately the ability to deliver care.
Our goal isn't simply to find someone who can do the job.
It's to help you find the leader who makes sense for what comes next.
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