What we do
Whether the challenge is a stalling transformation, an AI strategy that hasn't moved past pilot, or operational costs that won't stay controlled — we start by identifying the actual structural problem before recommending anything. Most engagements begin with a focused diagnostic.
For organizations navigating high-stakes, cross-functional change. Successful transformation requires both sound strategy and disciplined execution across the human dimension — from problem framing through sustained adoption.
Directed a $900M cost structure redesign across a large integrated health system.
Launched and scaled multiple enterprise PMOs from inception across a 300,000-employee organization.
Led ACA implementation for the most-affected commercial line of business — on time, in compliance, with revenue growth.
For organizations moving from AI curiosity to AI capability. The organizations that win with AI invest as much in organizational readiness as in the technology itself — building the strategy, governance, and human infrastructure to unlock real value.
Co-led an enterprise-wide AI business readiness program aligning business, IT, and applied intelligence functions at a 300,000-employee organization.
Delivered workflow automation, machine-learning, predictive-analytics, and AI-enabled capabilities that unified cross-functional workforce data, improved visibility into labor-cost drivers, and supported proactive management of unbudgeted expense.
Led business strategy, readiness, product, portfolio, and change work across enterprise platform implementations and transformations involving Epic, ServiceNow, Oracle, Adobe Experience Manager, and related technologies.
For organizations where fragmented processes, disconnected data, or operating complexity are constraining performance. Sustained operational improvement depends on aligning process redesign, technology, data, and people. We identify where complexity drives cost, where workflows fail at scale, and where automation or analytics can improve efficiency, visibility, and decision-making.
Consolidated 40+ local staffing operations into a single high-performing service center — improving satisfaction and reducing costs by more than $200M annually.
Developed a centralized business intelligence platform unifying telephony, scheduling, workforce, and HR data for a 23-hospital system.
Implemented the first non-IT use of ServiceNow within Kaiser Permanente to manage central work intake, tracking, and resolution.
For health systems, health plans, and integrated delivery networks. Healthcare transformation rewards deep insider knowledge — 25 years leading programs across health plan, hospital, and clinical operations inside the nation's largest value-based care organization.
Executed COVID-19 surge planning: launched KP's first inter-hospital patient transfer service and expanded bed capacity from 2,700 to 5,800 with full staffing and resource coverage.
Directed recruitment of 3,000+ nurses in 90 days during peak post-pandemic shortage, reducing travel nurse costs approximately $20M/month.
Managed ACA implementation for the most-affected commercial line of business — achieving full compliance and capturing market disruption as revenue opportunity.
For organizations that need experienced senior leadership on a flexible basis. Whether you need an accountable executive for an ongoing program or on-call strategic judgment, these models are designed around how real transformation decisions get made.
You work directly with Geneva Garske on every engagement — not a junior team with periodic senior check-ins.
Engagements are structured around defined outcomes and baseline measures from day one. If we can't measure it, we don't claim it.
For projects requiring additional capacity, we source and manage qualified associates — without adding overhead to your engagement.
How we engage
Most engagements begin with a focused diagnostic. From there, the model depends on what the work requires — a defined-scope project, ongoing program oversight, or flexible senior capacity.
Not sure which model fits?
Let's talk through it →Most engagements start with a focused conversation — no pitch, no proposal. Just a direct look at what's driving the problem and what it would take to fix it.
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