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Flourish: Leadership Here, Near, and Far with Lisa Davis, Janet Malzone, and Kristine Jarvis

GMT20250714-172930_Recording: I'm Sarah Richardson, a principal here at this week Health where our mission is healthcare transformation powered by community. Welcome to Flourish, where we share the human stories behind healthcare leadership because thriving people build thriving systems.

Let's begin

Sarah Richardson: Welcome to Flourish, a podcast that explores the people pivots and principles shaping modern leadership. I'm Sarah Richardson, and today we are unpacking one of the most complex questions in business right now. How do we offshore nearshore or automate the right work without disengaging our core team or losing what patients and customers value most?

We are joined today by three industry subject matter experts, and I'm so grateful to have this opportunity to share the perspectives with you. Ladies, welcome to the show. Thank you for having us. Thank you. I'm so happy to have you here. I mean, literally, I always love to give a bit of context.

This went from a conversation that Christine and I had to this amazing first time flourish [00:01:00] panel for a podcast. So I'd love it if each of you could share a bit about yourself with our audience. And Lisa, we'll start with you.

Lisa Davis: Thank you.

Happy to be here. I am a technology executive. I've been a Chief Information Officer for several decades in Department of Defense and academia. I am high tech at Intel and then spent my last five years at Blue Shield of California. I'm currently enjoying my portfolio career. Doing many different things including strategic consulting, some mentoring, and I'm writing a book about being the only woman in the room that's gonna come out at the top of the new year.

Sarah Richardson: Fantastic. We'll have to do a follow-up show and a book review for that. And for those of you listening, follow Lisa on LinkedIn. Her content is always phenomenal and very thought provoking. Janet.

Janet Malzone: Well, I'm also a fan of Lisa and her, her, her site, and I'm waiting for the book as well. It's got some great information.

I've already heard some little nuggets from it, so thanks for being [00:02:00] here. I have. 35 plus years in public accounting. So a very exciting career as an auditor. And people when they think auditing, they might not think of the people side and all the things we get to do. So I've got a lot of experience, not just in the auditing, but how to manage a professional services firm, risk management.

The modeling I've experienced, the offshoring onshoring and the implementation of technology and the changing. How we change using our people and the models through change over time

Sarah Richardson: and always has a focus on the financial implications. So I'm so grateful to have you here. Thank you. And Christine, the idea master behind today's conversation.

My goodness. So thank

Kristine Jarvis: you for having me. I'm thrilled to be here with you. Sarah, Janet, and Lisa. I am an organizational transformation specialist. I focus in on design and operational effectiveness, and I [00:03:00] have the privilege of having served in a global integration for finance, tax and audit firm, and also in some work for healthcare industries

Sarah Richardson: I wanna jump in to really. Chatting about what suffers most when we move work offshore, nearshore, or outsource it and protecting what leaders need. I think about it in being like three different tiers of a framework. You've got, you know, the in-house component, which could be tier one, tier two, which is maybe nearshore, and then tier three, that offshore perspective and what it means for our teams when this happens.

So Lisa, I'm gonna start with you. What are the biggest misconceptions that leaders have about automation versus outsourcing?

Lisa Davis: I think the biggest mis misconception, misconception that we have is that automation and outsourcing are interchangeable, and actually they're not, because automation is about. How work gets done and [00:04:00] outsourcing of course changes where the work gets done.

Treating them the same causes leaders to make the wrong investments, and many times those investments are also not aligned to strategy. Or clarity in how the leaders are communicating to their organizations as to why we are outsourcing, or why we are automating and driving to those specific outcomes for each one of those separate instances.

automation can amplify your processes. What I have found in outsourcing and that it actually exposes the weakest ones that you have in your organization. So because those processes and that outsourcing is where your data, your workflows need to align, and both of them need to be aligned to the strategy that you're communicating to your organization.

Sarah Richardson: And there can still be [00:05:00] the misconception that automation means it moves out of the organization. Yeah. And Janet, from a financial lens, what's the hidden cost or overlooked advantage of these sourcing models?

Janet Malzone: And that's a great question because when you think about it, it at first on the surface seems really simple, right?

If I have an hour that I've done. In the US and I wanna send it somewhere else or automate it. It's a one for one, but, and then you have a labor arbitrage. Let's say you offshore it, so, oh, I took a dollar, a an hour in the US and put it somewhere else, so I'm just gonna work the same hour and I get that savings.

It's not that simple because a lot of times that offshore work requires a little more coaching, a different level of review, a little different training, so it's not that one by one. And so it's reducing that headline savings everybody thinks they have. Then you go take a step a little deeper and maybe we have some communication differences and work styles.

So [00:06:00] we've gotta have a lot of differences in how we train and onboard. We can miss some of the knowledge transfer. How have we always done it here in the US It's not gonna translate. So we've gotta redesign things. We have to keep quality the same and calibrate our documentation so it seems simple. But it's not that simple.

And if you don't do it right here's the risk of not doing it right. You can lose your differentiation. And what does that mean? If you don't get all those components right, you can damage your brand because you're not delivering consistently. You're not having the same service level external to your customers, or even peer to peer, how you work together.

So that can cost the company culturally and you can do brand damage. So you gotta be very careful when you're looking at all the costs.

Sarah Richardson: Well, and the cost of how long it takes to reach that equilibrium of potentially what you had before. Like you don't, you're not just replacing one to one ratios in some cases.

Which Christine brings me to a question for you is how [00:07:00] can leaders ensure that emotional intelligence stay central in sourcing decisions?

Kristine Jarvis: Well, don't leave it to chance. Right? Or personality. Think about how you're gonna build that into how you choose your partners. Right? And emotional intelligence probably isn't a nice to have.

It has to be wired into the way we're making decisions. That means we have to look at our SLAs and say, what's it? I like to actually work with these people. What will it be like to when it gets messy? 'cause things will get messy. And so you want to have some practical, visible mechanics built into the questions that you ask when you're sourcing.

You wanna have some clear criteria and rating for the folks that you're bringing into the organization and how they handle situations, tension, pushback. We have all experienced some communication conflict in these types of situations. How do you work through those and how do you make sure that everybody walks away feeling confident in continuing that relationship?

And I don't think this just stops like. [00:08:00] Kinda once, you know, the agreement is made and then we're moving forward with, this is something you have to practice daily. And so I think it's really important that you show up as leaders in a, from a position that allows us to give us resilient relationships and move us forward successfully in the long term.

Sarah Richardson: Now we have what I like to call the shock wave of AI because we're already, to a degree, having the conversation about people learning how to manage agents. So now you're gonna be managing computers and really struggling to deliver it in a way that's meaningful at this interval. And Lisa, when you. Speak with organizations, how are you helping them prepare for jobs that don't yet exist because of not only the AI implementation factor, but also the fact that we had a conversation with one of our partners recently who said, take every job description off of your website if you were a healthcare [00:09:00] system that is not clinically focused because there's probably a level of automation, ai, or otherwise, that can now be central to that staffing model.

Lisa Davis: Well, this is certainly a hot topic and one that I think many times we think of it from a tactical lens in terms of the use of ai, the use of automation no longer requiring people to do that. And I am actually trying to flip this conversation because we go through this. Training or new skills every time there's a new evolution of technology, whether it was cloud technologies that we've been talking about for 20 years, digital technologies, ai, now we're in agentic ai and through each one of those waves, was there a need to learn new skills?

Absolutely. But we should also be thinking about. How we are training our personnel in terms of skill sets that can be [00:10:00] applied no matter what the technology is. So if I'm focusing on critical thinking, digital fluency, understanding data, ethical decision making systems, thinking, if I have people that understand and have these skills that can learn.

Adapt and apply whatever technology is of that moment. Those are the folks that I wanna invest on the team. So instead of thinking of AI as. It's detracting from the workforce. I wanna think of AI as amplifying these critical skillset that are necessary no matter what the technology is. And if I have a team that has those skill sets, there's no doubt in my mind that they will be able to learn and adapt and apply the technology to improve mission outcomes, company outcomes, et cetera.

Sarah Richardson: So, Christine, I'm gonna go to you on this one, because they have to [00:11:00] be back to being emotionally prepared. They have to have the ability to understand the empathy that comes with the learning curve. Some may make it, some may not. Are you just closing recs? Are you actually reducing staff or sending staff to other locations?

What needs to be true for people to be ready for a technology that's moving faster than anything that's ever happened to them before?

Kristine Jarvis: Yeah I think it's important for us to think about how do we shape and reframe the conversation, right? Instead of, this is going to take my job. We have to say, this helps me do my best work and really demonstrate how that happens and show them that they are respected, they're, they feel understood.

Studies are showing now that AI interactions that have a sense or a feeling of more empathetic responses and emotionally attuned, have an ability to make people feel more engaged and want to use AI in their workplace. And so I think it's really important that [00:12:00] we find ways to unlock and control clarity in and around how we're gonna leverage AI in the workplace.

Make sure there is a lot of open communication about. How you leverage the systems that you're going to put in place, and more importantly, make sure that it's consistent. the same messaging is consistent across the board. I think emotional intelligence is critical in this. If leaders kind of ignore this fear that people have of AI taking their job or whatever it might be, job insecurity, concerns about their inabilities, to upskill, quicken up, all of those things, if we ignore that, folks can't get to where we need them to go to adopt new ways of working. And I think that's a critical path in adoption of AI and in organizations.

Sarah Richardson: What I find super fascinating is the aspect of value and investment, those returns. And Janet, what I am loving is all these companies showing up and saying, but we can help you do these things better and faster and cheaper.

And the teams that are [00:13:00] being given this message. Sometimes feel like, well, wait a minute, we've been doing a really good job all along, and now they come up with a message. Well, we're gonna go after the top 3% of what you were 97% doing correctly in the first place. What is the real ROI threshold that companies need to watch before they decide to scale or implement an AI project?

Janet Malzone: The, well, there's a lot to think about and before I jump into that, I did wanna. Go back and kind of draw on what Lisa and Christine said. 'cause I really go back to like you said Sarah, that people are like, we've already been doing a great job. And you think about technology's been there, AI's been there for years.

And when I think back 35 years ago, which is now a long time ago, the things that I did when I first started are gone. They're gone. And then the people we hired. 10 years ago, the stuff they did when they started are gone. So it's always been an evolution. And now there's some fear in the system because of all this hype.

And Christine, you were saying that there's this fear. [00:14:00] So the leaders, those empathetic leaders, when we talk about talking to them, they have to give them. More information to build trust. 'cause without the trust, then fear exists. So that goes back to the leadership in making sure we get that. So now the leaders are coming to us and saying, well, okay, we gotta change this.

I need a high ROI. What does that mean? So before you can start calculating that ROI. You have to really understand where are you? I've, I might have a spend before I spend on this AI use case and project that I wanna do. So you need to first understand where am I with my data? Am I in a technical deficit already?

Do I have to catch up? Do I have to clean it up? Because I can't just apply a AI solution if I don't have the right foundation. So first you need to calculate that 'cause that might be a large cost. To get you there. So you need to understand the cost, you have to determine to get to that ROI and timing, because it's not just the return [00:15:00] on investment, it's that value.

'cause I have to have value in the system. And this is not a simple model, just like we talk about outsourcing is not a simple model, nor is this, it's not a lift and shift. It's not a, if I take out this particular software, this particular head, I'm gonna have this return. So, and something that we've seen, I've seen over the years is when you're talking to your clients, let's say you're in a client service business.

Oh, if you replace people with technology, my cost is gonna go down. I'm gonna get a savings on my fee. And that's really not an accurate statement as you know. 'cause the tech has a cost, the subscriptions have a cost. The people to run, the tech has a cost and then that learning curve goes up. All of a sudden the people we're gonna have more talented people doing that.

People focused. Uh, The strategic thinking, the hard, the more crucial things. So they're gonna be more specialized. They're gonna cost more. So before you place your bet, you need to understand all those components. And you also need to do some pilots before you [00:16:00] go big, before you go scaling to get those right use cases, and then make sure you've got it right before you lay it out.

And one of the things. I've seen, and there's some studies on this, that the highest return on investment on projects are the ones that the teams had the highest disagreement on, and they generally have the highest return versus those that your company has the most agreement. So you need to think about that, of I'm missing something, that we've got this violent agreement and maybe we need to explore where we're not in agreement.

And one way to. Mitigate that return on investment is to do something called a pre-mortem. And Gary Klein developed that particular pre-mortem method. So it's very interesting. You can do some reading and about that, but you get your team together before you start on this project. And you talk about that this project that we're gonna endeavor on is going to fail before you start.

It is going to fail, Not. Maybe it'll fail. It has failed. So you [00:17:00] talk about this before you roll it out, because when you do a postmortem, everybody's pointing fingers, why did that happen? And everybody's defensive. If you go in before it's happened, everybody's mind's open, what could go wrong?

What would've killed it? Now you're coming up with the real problem solving of what is knowable, what is controllable, what can we fix? Then you have a higher level of success. You can fail fast and it's not gonna cost you a lot of money or as much money because you're identifying these things quickly because these are big investments and you wanna do it right.

So some things to think about before you move forward. So as

Sarah Richardson: we've discussed a bit about moving teams to different offshore nearshore, even automated opportunities, when you start to break up the culture a little bit about the ability to do a pre-mortem where you're having healthy conflict and dialogue beforehand when your teams start to be dispersed and even if they're contracted to you, that actually work for you.

How would you adjust a [00:18:00] model like that? How do you start to bring those people doing some of the most important work in your organization? Granted, it could be routine work, but still very important to the bottom line and to how the organization is functioning. How do you bring them into the con, those types of conversations.

Lisa Davis: Yeah, communication. Communication is absolutely critical. And I've always said as a leader, I don't know and I think there's a data point on this, how many times do I need to say something or repeat something so folks really understand what is it we're trying to do? What is our strategy? What is the purpose?

And even more importantly, what are the outcomes that we're driving to? And when you're working with teams. Global dispersed teams. It's almost like the telephone game because there's a piece of information that seems to get lost. It even happens when you have the entire organization all in one place.

So you can imagine the complexity when now I have a global diverse team and [00:19:00] I have to ensure the intent. The messaging and the outcome is so crystal clear in how I'm communicating it so everyone is driving to the same. Outcome, and that takes a lot of leadership engagement, a lot of communication, and showing that we have alignment across the organization and we're all hearing the same thing and doing the same reasons for the same purpose, but it requires definitely a concerted effort.

Kristine Jarvis: I love what you just said about that, Lisa, because I think that core question that really needs to be asked is what does this do to the trust? Yeah, to the belonging, to people's belief that. The organization that they work for is still a place that they actually want to continue working for. And this shows up in engagement in the way how people stay involved or how people kinda lay back and they don't engage or they don't leverage the offshoring [00:20:00] options that are available to them.

And so I think it's really important that communication that you talked about is just airtight at all times and really focuses on the cultural. Kind of integration of your organization. If you're offshoring in some of our locations in India or in the Philippines or in those in.

Those locations, you know, the way a person says yes is vastly different than how you and I and Janet will perceive a yes. Right? And so it's that culture education that has to happen in order for people to successfully work within this offshore nearshore model.

Lisa Davis: It's such a great point because I'm re reliving my intel days where I had teams in China and Malaysia and Costa Rica and Europe and Janet has called it out and you have called it out.

Christine, is that element of trust and belonging to the team and the organization. And another element that [00:21:00] you can add on this is when those teams are contractor teams that are outsourced versus full-time equivalents. That are part of the company. So now you have even maybe an another added layer of complexity of even though they may be a contracted team that's offshore, how do I make that team feel like they're part of the bigger team and the bigger mission?

And I belong and I'm a member of that team, and I remember that required. I would go show up in Malaysia, in China. The leadership team? Mm-hmm. What do we need to do to make those teams feel like they are. A part of the organization and the work they do matter and impacts outcomes that we're driving together, you know, together.

So it's such an important point to call out

Sarah Richardson: and once we've made the decision, we may say, Hey, you know what? We're gonna offshore so you can focus on higher [00:22:00] value, strategic problems. We have to reframe the sourcing and automation as an opportunity. Yes. For growth, not elimination, and yet there's things we all need to be worried about.

As we go through these types of decisions and processes, and so Lisa, how do you foster both the technical fluency and the leadership maturity at the same time?

Lisa Davis: This is such an interesting question to me when I was thinking about this, because you can't. You can't have one without the other. 'cause I thought initially.

Okay. And I've been in these situations where you have tech fluency. the tip of innovation. You're driving innovation and modernization, but you have a lack of leadership or leadership maturity. And what does that create? Usually chaos is usually what we get, right?

Mm-hmm. On that far end of the spectrum. And then if you flip the equation and [00:23:00] say, oh my goodness, I have leadership maturity, but I lack tech fluency, and what you get there is possible irrelevance. So what you need is both and frankly. It's hard to find because finding that technical fluency and having the leadership maturity.

Integrate it and working together is ultimately what is going to create success for the organization. So understanding that and focusing on that to make sure that you are creating both within the organization I think is key to how we leverage and show how the technology can really drive meaningful outcomes.

Sarah Richardson: I think about that as almost a chicken and egg scenario. Yes. Can you teach people to have the leadership capability to understand the technical capabilities that are out there? I feel [00:24:00] like the technology's already there. Can the humans get there fast enough? And not just understanding it, but being able to get a following to help people wanna do those things as well.

And so, Janet, I'm curious from your perspective. What is an example of a time your organization you've worked with has turned a sourcing shift into a leadership opportunity? Like how do we help people actually get there?

Janet Malzone: really. Being strategic about these opportunities is part of it.

We've talked about the communication, leadership of pausing to say, this is an opportunity because you think about, I'm going to, I might have an executive sponsor for doing this shift. So now how do I project management? How do I bring in the level that the level of the team member. That I want to give an opportunity for kind of like you're saying of how can I turn it into leadership opportunity of not just having the leaders do it, of saying, come on, now [00:25:00] we need, let's bring up the middle management.

Let's bring up that group to say, I want you to project manage. I want you to be engaged in this because it's gonna bring them to the next level. It's gonna get them into the details. It's going to get that next level of your team. Supporting it, understanding it, getting the buy-in. 'cause that buy-in from the middle is so key.

So what you do is you bring them in to several stages. There's plenty of stages to bring in other people for leadership, be it the project management, be it in the pilot stage to give the feedback, to be in a group that are going to do the rollout and implementation and be that leadership voice. And once they get that buy-in.

And actually share with others that, hey, I was part of the trial group. I did the pilot. I gave them feedback. They took that feedback, we delayed it because of that, or we changed things because of that. Now you've got a whole group in the middle that have now owned [00:26:00] something they're bought in. And what does that also do?

We've already talked about. It brings in trust, it helps with our culture, preserving that culture for that rollout. Now they've got new tools in their belt. They want it to be successful 'cause they were part of the process. So to me, you can't just throw something out there, just trust us. We'll, we're gonna, we're gonna get to 20% integration.

It doesn't work. Trust is earned from leadership. One comment at a time. One different conversation, one-on-one through transparency, listening and showing that feedback actually influenced decision making. So the, these are actually perfect times to bring in people to develop their leadership.

Kristine Jarvis: Janet, that's such a great point because you think about, there's this business model, right? That's tech, that's the finance model. That's all the cost savings that the organization is offer, and efficiencies they're looking for. Then there's the human model. And the human model is often one, [00:27:00] the one we do not spend any time really investing in.

But if you put those culture metrics up against, you know, the business metrics, I might imagine that you're gonna see some clear and define the thresholds that the organization is actually willing to cross. From a culture perspective, what are you willing to do with your people, with your leaders to get them to buy in?

I think you'll have far more. Clear decision making and you'll have a higher retention of said staff. Mm-hmm. And willingness and engagement to grow in the organization and really work together as an organization. So it's a great point you

Janet Malzone: bring up there and that cross section, what we're saying is how do you get people from all over the world?

Well, we're gonna take in people, we're gonna have people part of that group, not just from the us. We're gonna have it from both sides. So we're gonna make sure. We're catching the stuff at the beginning and getting those opportunities across the organization and making everybody feel valued. How do we talk about our whole global workforce?[00:28:00]

Kristine Jarvis: Yeah. But the positive gossip, right? Mm-hmm. You talk about positive gossip in previous conversations and making that an integration opportunity for all leaders, and that's just a great terminology. I love that.

Sarah Richardson: Christine, what's the best way to keep your pulse on the cost of that cultural transformation?

We have metrics for just about everything that we're implementing and doing, and I've rarely seen a business case or an ongoing model that says, culturally, this has been the impact on our organization. What are some of the things we should be looking for?

Janet Malzone: So, such a great question. It goes back to you can't really put this on a, a.

Balance sheet. Right. You've gotta think about some poll surveys you have to think about during and after the move. What kind of surveys can you take regarding trust in the leadership, the clarity, the communication, sense of fairness. Right, that really does matter. And confidence in the future of where the organization is leading.

You can think about or watch your attrition, any [00:29:00] type of like regrettable turnovers, any internal mobility of changes that people have made. Those are all internal sources you can leverage as well. I think. Cycle times for work make a huge difference. That's a very solid metric and how people are working together, their ways of working together will demonstrate how well something cycles through.

And so those are the areas that I would focus on if I were measuring a global transformation.

Sarah Richardson: I can't help but think about. The fact that global tech and financial giants continue to shape our digital future. And then there's this whole space of leadership accountability that has a beginning and an end.

A lot of the communication and even fluency that we have talked about, there is a need for the inclusive, ethical decision making in either sourcing and or some of these AI integrations And honestly. Research shows female leaders, holistic and systems based thinking may be the win here because it's essential for sustainable transformation. How can mid-sized [00:30:00] organizations remain value driven Amid so much of this global consolidation.

Janet Malzone: I'll jump in on that one. And I love how you say that some female leaders, I think a lot of this starts with inherent empathy and also creativity and how we problem solve. And it has to all start with landing on your values. You have to be always aligned with your values. Yes, we need governance.

We need to focus on what are organizational values and our culture, and understand as a leadership team, bringing in the voice from that leadership team that is your guiding star, that is your non-negotiable. So always having that lens, if I'm gonna make decisions, I've got my strategy, I've got my values, and I've got also my non-negotiables is it qualities my people because it's easy to fall into the hype.

I'm, I've gotta get this done fast. I've gotta go at speed. I've got, I [00:31:00] wanna, we've got to get there quickly. We've got to yield the results as fast as possible. And if you run that fast without the c all the components of communication, change management culture, you've thrown your values out the window and you've lost your brand, you've lost your way.

You might as well say, let's just put this up for sale and call it a day. Sticking with your guiding stars, your non-negotiables have to be in the conversation and having that room, having a diverse room that's actually standing up and pointing those things out and having those commitments that we're gonna keep all of these as part of our foundation as we move forward, and it can be done.

We've seen it done time and time, but we've also seen it go the other way. And when you just let go of that foundation, it gets, you're on a very slippery slope for your whole organization.

Lisa Davis: I'll add [00:32:00] on to Janet. I think one of the biggest mistakes folks make in driving a transformation, and I love Sarah, how you call out, you know, female leaders.

'cause frankly, this is our superpower. We're system thinkers and when you're driving, whether it's a digital transformation, an AI transformation. It's never about the technology. The technology is just one swim lane and the broad transformation you're driving in just like Janet called out. It's always about the people.

It's always about the process. Technology is a part of that without having all aspects of people, process and technology, and that includes culture, quality, ethics, customer trust. Incorporated into that transformation framework. Not that's my free word, but frankly that's what it is. It's a broad framework of how you're going to approach the transformation [00:33:00] across the company.

And if you neglect, let's just say one of those swim lanes, you likely, it'll wind up costing you more money. It'll take you longer amount of time to do it and. You may not succeed at all. So viewing it holistically and using that systems' thinking of this will affect the entire organization. And I'm a huge fan of Kotter.

I always have been from a change management. And as you're building out that transformation. Building in that stakeholder alignment, finding the folks of the, the naysayers in the organization, getting them to buy in. Building change. Catalyst. Catalyst, getting quick wins, small wins that build that momentum.

Of energy, inspiration and excitement to keep going because transformations are hard. It takes a long time. They're not gonna happen [00:34:00] usually within, oh, I'm gonna knock this out in the next three to six months. No, you're not. It's usually a multi-year process, so. Just remembering that it has to be a holistic engagement, and that's where system thinkings come in is why that leadership driving that transformation is so important.

Sarah Richardson: I love TER as well, and I always tell people there are eight steps and you should pay attention to all of them. That's right. Maybe some in different like levels of uh, leading into them, but they all matter throughout and that's why I always tell people, if you don't have a good change management framework about 70 to 80% a year initiatives or they're gonna fail or be significantly delayed or cost more.

Christina, Kristine I have to ask you this question then, because you were all about the organizational transformation aspect. When we mess this up, what. Does it actually take to bring the culture back to good? Is there a timeline or a horizon that you have witnessed when we say oops, and now whether you're bringing things back in house [00:35:00] or having to reframe some of those conversations, what does it take to rebuild a culture?

Kristine Jarvis: A writer and author by the name of David White who says, transformation is to hit present reality at high velocity and watch it break apart at impact. Right? We go into transformations thinking we're just going to do.

One or two little things in an organization. It's never one or two little things. It work has to flow successfully through an organization. And so you have to recognize just what Lisa was talking about and what Janet was referring to as well. If your work flows through an organization, you are touching everyone and therefore you're touching the culture and the foundation of your organization.

If you break that foundation you've done so by uh, breaking trust. First and foremost and building trust is not a, you know, six month process. It's not an 18 month process. it can take years to rebuild trust in an organization again. And oftentimes it will take [00:36:00] leadership changes in order to recapture your cultural foundation that you once had, because it'll take somebody coming back to reset and refresh, or it will take a leader and a leadership team to stand up and say, we have failed.

And when leaders stand up and say, we have failed, your organization is likely to turn around and start rallying behind and say, okay, how do we help? Because somebody took accountability. Accountability is critical in resetting a culture if you don't have a leadership change subsequently to a failed transformation.

So you bring me to the question, but I'd like to hear what the others have to say about that. 'cause that's a great question. Well, for

Sarah Richardson: sure. 'cause I'm curious, like what are the principles from a leadership perspective that Yeah. You, that keep you grounded in all of this change?

Kristine Jarvis: Yeah. Certainly for me, for as a transformation leader, communication, consistency, and transparency at all times.

It's never an option to not [00:37:00] tell the truth. You can withhold information because the organization may not be ready for that right now. But you cannot lie, you cannot blatantly lie because people will see it, they'll feel it, they'll experience it in their day-to-day interactions with others.

Lisa Davis: I love those.

And in addition to those three words, I think I'd add one more quality. Mm-hmm. Because what we're doing, and people have to see it and they'll know it whether we're driving actually quality and impact and the work that we're doing day in and day out.

Kristine Jarvis: Mm-hmm. Mm-hmm.

Janet Malzone: I, and I couldn't add another word to that list of four.

Sarah Richardson: I feel like I have to throw a trust in there just 'cause we've talked about it so much as well. Right. But I'll tell you, for all of us that have done these in our careers, that whole sense of urgency, which is part of that whole change management model, it could be important to you. And if it's not important to anybody else, it just like being, you're not going anywhere.

Mm-hmm. That rock said, keep rolling over you at the end of every single [00:38:00] day.

Janet Malzone: part of my communication to get to trust with that consistency and transparency is what is in it for me. I'm not just doing it because you said so.

It's because that goes back to tell me why it matters to me, how it doesn't harm me, how it helps me, right? Mm-hmm. And a little bit of how did we get here? What is and mm-hmm. Some of why are we doing this? It's like, okay, I, I can see how you got there.

Lisa Davis: And you know, there, there are cracks that begin to form while doing this.

When people see that the entire leadership team and the boss is not aligned and engaged and making a transformation successful, and it only takes one, and that person says, oh, well, so and so. Doesn't think we should do X, Y, and Z. So that leadership alignment and engagement top down is a critical [00:39:00] element of having the transformation be successful.

Kristine Jarvis: I had this experience with Lisa, and Lisa probably will never remember this, but, or you might, but I was working with her on a transformation in one of the, our shared organizations. And we had a wonderful professional services firm helping us at the time, except they weren't getting to where I wanted to go.

And so I paused the whole meeting and asked the question, so how are we gonna do that? And Lisa stops, I'll never forget this, and said, can anybody answer that? And because that's one of the best questions that have been asked at this. In this meeting today, and I, it was a pivotal moment for what hap what subsequently happened, but also for the organization to be able to understand that we are building this together.

It is not just one person or one group driving something. Anytime you go through a transformation especially an offshore transformation, it is a together [00:40:00] thing and people have to get on board. Strategic alignment has to exist. I've seen I've actually done this with Janet too a few times. Wow.

This is so fun. Anyway.

Sarah Richardson: Well, and that's why we're here because, I mean, we've covered some pretty heavy space, but when you have rapport with people and you've done hard things before, it's fun to look back and say, oh yeah, we did that, or we did this. Knowing that, I mean, my goodness, if y'all ever got that band back together, what you could do next.

But that importance, you have those people, they're your lifelines that are out there. It's time for us to have a little bit of fun though, with all this heavy conversation. And so Christine, this one is for you. What is one thing you would never offshore?

Kristine Jarvis: Do not ever offshore, your change management communications training, or anything that touches the human element that needs to stay on shore and work with the people so that you can reach everyone holistically.

Sarah Richardson: Okay. And for you, Janet, what's a function that's better near shore than in-house?

Janet Malzone: For me, that nearshore [00:41:00] would get me to the finance function.

Sarah Richardson: What about finance? For the people listening that are sitting there in your business office, like doing prior auth and doing referrals and doing all of this management, what does that mean for them?

Janet Malzone: So for me that, you know, it, this goes back to, you know, we are looking for those efficiencies. Some of the people we're gonna have, we've got that upskill opportunity and also. What I have seen over the years, and it is amazing, we are all overwhelmed. The finance teams are overwhelmed, so it's not this, oh, I'm gonna take all the jobs we have today and we're gonna move 'em out.

We're gonna get you the help you need and get it somewhere that it's close by. They've got the right skills, so it's gonna lift that existing group up because finance teams, the more regulations, the amount of work, the amount of growth that has been happening, and the [00:42:00] lack of people coming into the finance teams, out of schools, into accounting, into the finance teams.

It's a constricted base. So there's, there is this huge need and so it's how do we boost up our existing teams?

Sarah Richardson: It's that piece. I wanna walk into a rev cycle team and say, we're gonna take all the things you hate off your plate. I mean, yes, it'd be like this huge up like roar of like, what are you gonna take?

And, our boss asks that, ask us that all the time. What do you not like doing? Exactly. And how do you find a way to automate it? And it's such a way It's changed. Mm-hmm. The way our organization thinks about automation and they, like, you can take the stuff I don't like off my plate. Yeah. I'm in. What does that, what does it mean that I have to do?

Lisa Davis: It's a great approach. It's a great approach. We actually had those conversations with the finance team and Rev cycle management was one of them, but it was always, they weren't able to find the dollars. To focus because we were always so capital constrained, and that's one of the things with automation and AI requires.

Really [00:43:00] prioritization because you can't do it all and you're not gonna be able to do it all well. So get really laser focused on what is going to be the biggest bang for the buck in terms of where you're gonna leverage the technology to really help the business and really drive to smarter, better outcomes because of it.

Kristine Jarvis: And so, Lisa, so Lisa, is that location agnostic? I'm just curious. Yeah.

Lisa Davis: it may be location agnostic. You know, when I think of location, I always think in terms of differentiation of IP and skillsets and where does that IP need to be protected in. If you're asking me in terms of what skills would I be move near nearshore or offshore or keep in-house from a technology lens, I'm thinking.

Keep my IP close differentiation of what I'm bringing to the table, and then look for nearshore and shore of where I can get skill sets, maybe [00:44:00] that I have a shortage in the states, and also drive and help us meet what we're trying to get done there. So similar for finance. Thanks Sarah for letting me interrupt.

Sarah Richardson: No, well it's, I mean, it's important because there's certain things you just you know, it makes sense to diversify your workforce in whatever way possible. I mean, ever since COVID, people are so much more open to that conversation. Mm-hmm. And yet you can't be careless with the ability that just 'cause we can be anywhere doesn't mean we should be anywhere.

Mm-hmm. So, Lisa, I have to ask you, what's the AI myth that five years from now, which feels like an eternity in the world we live in today? A couple years from now, what are we gonna look back and say, that was baloney. That did not happen.

Lisa Davis: I am counting on to spilling this, that AI will shrink the workforce and in fact, it will actually raise the skill bar and we'll create jobs that we haven't even yet imagined yet.

Sarah Richardson: You heard it here. I mean, for everyone listening, this will actually increase the capabilities and maybe increase your workforce, but just think of how [00:45:00] much more you can deliver to your patients, to your clinicians, and to your employees. One last question for all of you. When you think about leading a global workforce, what does that mean to you?

Janet Malzone: So for me, it's my global workforce is delivering on the same level of quality. So I'm always gonna start with quality. That is my non-negotiable and that's what I would expect from a global workforce.

Lisa Davis: Love that answer. Janet. I'm gonna go with authentic leadership and clarity in the messaging across that global workforce.

Kristine Jarvis: And I will wrap it up with consistency in that workforce and process and people and the way they're treated and in the technology services that are available to them.

Sarah Richardson: I love all of those and how important they are for the ability for a organization to keep thriving even when there's unknown change coming.

If you have good frameworks and good people and the technology support it, really anything is possible. That's right. Christine, thank you for bringing this amazing group of [00:46:00] women together. We have truly touched on the fact that the future of sourcing isn't about geography. It's about philosophy As AI redraws the map of work, leaders who flourish will seek global talent as an ecosystem of innovation, not a cost cutting tool. Thanks for listening and keep flourishing.

GMT20250714-172930_Recording: Thanks for joining Flourish. Remember that every healthcare leader needs a community to learn from and to lean on. Find your people at this week, health.com/subscribe. Share this episode with someone who needs encouragement today. Keep flourishing. That's all for now.