When a coding manager leaves, the obvious replacement is often the best coder on the team, the one who knows the rules cold and rarely makes a mistake. The promotion happens fast because the work can't wait. Then the new manager is left alone, with no training, no coaching and no one checking in. The result is an excellent coder struggling to manage people, with consequences for the whole team.

That example came from a 2026 MGMA Annual Conference session on developing leaders from within, and MGMA polling shows how little groundwork most groups lay. Only 33% of medical groups had a succession plan for leadership positions as of February,¹ a share that has barely moved since 2019.² In a March 2025 poll, just 31% said some non-managers have leadership development goals.³

Two 2026 Annual Conference sessions offered a practical alternative: develop people before they have the title, and use real work to do it. Melanie Stohl, MBA, PPMC, director of pediatric specialties at University of Minnesota Physicians, presented "Manager to Multiplier." Michelle DuJardin, JD, FACMPE, FACHE; Lauren Ditaranto, MBA, MHA; and Jessica Marchione, MSN, RN, CCRN, NE-BC, leaders in the Hough Family Institute for Brain Protection Sciences at Johns Hopkins All Children's Hospital in St. Petersburg, Fla., presented "Developing Leaders from Within." Their approaches line up closely.

Spot potential before a vacancy

Stohl's starting point is that potential often shows up before polish. She looks for curiosity, influence with peers, a habit of noticing gaps and acting on them, the ability to see connections across the work, the courage to raise concerns, and use of feedback to improve. She also separates how well someone fits their current role from their capacity to lead.

One of her examples w