How This VP of Finance Handles Two Separate Health Systems

With twice the responsibility, see how this finance VP makes it work.

Elena Barberis, CPA, has accepted the role of Vice President of Finance for both Trinity Health Holy Cross Health in Fort Lauderdale, Florida and St. Mary’s Health Care System in Athens, Georgia.

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Over the past 18 years, Barberis has served in leadership positions in healthcare systems in the Miami and Atlanta metro areas. She spent 11 years at the Jackson Health System in South Florida, rising to the position of vice president of finance.

It Takes A Village

Being the VP of finance for two different health systems is no small task.

First, organization is vital, she says. From differing payer mixes to population metrics, to operations, being extremely organized is something Barberis knew well long before her dual role. Now it’s helping her keep both health systems in check.

“My whole career, I think and my whole life, has been developing the strategies to get organized and to be equipped to handle this role,” she said.

Secondly, it takes the support of a good team. With several levels of finance support teams at her side Barberis said: “It’s one of those things that really gives you that village and the support you need to be able to handle everything.”

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On top of this, consistently monitoring the economy and regulatory policies is also a significant part of the job, she says.

Barberis said one of the strategies that has helped her throughout her career is determined and resourceful collaboration. She recalled a time early in her career where she had been brought into a health system as part of the financial turnaround team. When she found herself unable to get the information she needed, she used her communication skills and collaborated with the colleagues she needed to get the work done.

“Basically I just went around and used all my communication skills and tapped into meeting people,” she said.

Too often in healthcare, and especially in healthcare finance, executives find themselves making decisions in isolation. With so many financial pressures coming from all around, it’s no shock when CFOs want to phase out the noise and simply get the job done. But isolated decision making isn’t practical and can often lead to uninformed outcomes that can affect just about every aspect of a health system.

But Barberis has found a collaborative system that works at her organization, where finance isn’t a scary, off-limits topic to non-finance staff.

“One of the things that I think has been a benefit for me, is that I’ve been able to reach across the aisle to colleagues and to folks that are usually not comfortable speaking about numbers,” she said. “It’s very helpful to be able to do that when you can.”

For a VP of finance, the most crucial collaboration, especially when dealing with multiple health systems, is the collaboration with the CFO. Barberis manages her two health systems along with CFO Michael Gussow, who regionally manages four locations for the health system. 

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Barberis emphasized how her CFO helped her as she settled into the new roles and she knew her success was on his radar from the beginning.

“It’s been a wealth of knowledge for me to learn from him,” she said.

Looking Ahead

Looking down the path of the rest of 2025, Barberis says she’s keeping a close eye on regulatory changes and reimbursement models.

 “Trinity, as well as many other health systems, has been very vocal about negotiating with payers and getting a fair negotiation, and a fair rate with increasing dynamics in the market,” she said.

While insurers are raking in hefty profits, health systems are still struggling.

“Margins are getting thinner and thinner for hospitals as costs continue to rise. Prices continue to rise on drug costs,” she said. “Things are not getting any cheaper, especially with inflation.”