During her tenure with PAMF, she has served in leadership positions including Chair of Professional Affairs, Department Lead for Family Medicine and Primary Care Division Head. She started lean work in 2008 on primary care design and development of a primary care model line through 2012. After serving as a physician consultant, she became the medical director of the PAMF Lean Promotion Office. Since March 2015, however, she's returned to the front line, practicing medicine full time and facilitating local improvement projects and serving on the Sutter Primary Care Innovation Steering Committee.