This is the second time around the Crescenz VA Medical Center for Karen Flaherty-Oxler. From 2001 to 2007, she served as chief nurse for patient care services.
Now she oversees around 2,700 employees with a budget of $559 million.
She's aware of the layers of bureaucracy that are wrapped in those figures.
"I'm gonna come at this from a perspective of building upon the strength of the talents that exist here, adding to their portfolio of experience and challenging them. I would suggest to do more, to do better, be stronger and truly to each day raise your game. And they will hold me accountable to do that and I will hold them accountable to do that," she said.
As for her gender, the 66-year-old Flaherty-Oxler says the time spent working her way up to the rank of admiral prepared her well for the pioneering role she's undertaken at VA.
"There were days I was the only female at the Pentagon and you best believe I was gonna have something key and pertinent to say about the care of our Navy and Marine Corps colleagues," she said.
Flaherty-Oxley has also had an active civilian career, serving key roles for Atlantic Health System and General Health System in Lancaster.