How to Become a Skills-Based Organization on a Large Scale

BY Katie Chambers | March 12, 2025

Covid put healthcare professionals’ skills to the ultimate test and redefined how entire health systems are organized. This was certainly true at Memorial Hermann Health System. Lori Knowles, SVP and CHRO at Memorial Hermann said it was a time of “rapid-fire decision-making and precision.” 

Knowles spoke during a fireside chat at From Day One’s Houston conference, interviewed by Jennifer Vardeman, Ph.D., Director and Associate Professor at the Jack J. Valenti School of Communication, University of Houston. “People were exhausted, but they came together for the community and for each other in ways that changed the fabric of the organization and what we believed we could do,” said Knowles.  

As the biggest healthcare system in Texas with more than 34,000 employees, Memorial Hermann is moving toward becoming a skills-based organization, in which jobs and careers are remapped to focus on skills. The goal is to improve employee recruiting, retention, and quality of care.

HR as a Problem-solver

As a fully integrated health system, Memorial Hermann encompasses everything from hospitals to outpatient care, physicians, urgent care centers, and health plans—all driven by its mission of community support. “We are non-profit. The only health system in Houston that is community-owned, so there are no shareholders. We actually give back to our community to the tune of about a half a billion dollars a year in community care,” Knowles said. 

Given the organization’s wide reach, Knowles wears many hats in her role, overseeing not only the usual HR tasks of total rewards, benefits, professional development, and employee relations, but also chaplaincy and “a centralized float pool” of 1,200 floating caregivers that fill in for regular employees when they are on leave.   

But the fact that Knowles wears a lot of hats is not unusual to someone in HR. She shares that especially post-pandemic, organizations have been looking to HR for guidance on many major workplace issues, including mental health, wellness, resilience, burnout, and even rules on mask mandates. “That gives us an opportunity to prove that we are more than just the traditional functions of HR, but we are true contributors to the business who can think on our feet, and can problem solve in real time,” Knowles said.

Skills-based Professional Development

Many organizational obstacles can be solved through skill-building, either by hiring for certain aptitudes or developing them within existing employee rosters. After Covid, the healthcare industry was facing a crisis, including a nursing shortage and a lack of clarity for long-term career development as workers experienced burnout. At the same time, Memorial Hermann was having to overhaul its job listings to comply with nationally accepted pay transparency standards.

Knowles and her team decided to incorporate all these issues into one solution, redefining job descriptions in such a way that clarified pay and emphasized skillsets over years of experience, transforming the interpretation of the healthcare career track. “Let’s not just look at job duties and what experience you bring to the table, because the world is changing so fast. People don’t have 10 years of experience in AI, right?” she said. 

Lori Knowles, SVP and chief HR officer at Memorial Hermann Health System, left, was interviewed by Jennifer Vardeman of the University of Houston

The leadership team created a new framework for the 2,200 different jobs at Memorial Hermann and tried to identify where there were gaps. “For example, what we found in our corporate offices is we had very few entry-level jobs–-everybody has to have at least two years of experience,” Knowles said.

The organization used AI to scrape similar jobs across the country, identifying the 10 most prevalent skills attached to each job as well as the 10 most emerging skills, so that the company could understand both the current needs and the future framework for the role. This allows current and potential employees to visualize the pathway for growth and development, as well as helping HR better grasp succession planning and how to utilize the talent marketplace to create new teams. 

A focus on skills also takes the emphasis away from degrees, breaking down some barriers for talent that might otherwise feel excluded. Nurses, of course, need certain licenses. “But we are looking deeply at, do I really need a degree for everything? And if I do need a degree, do I need a master’s, especially if I have the skills that I can demonstrate [otherwise]?” Defining some roles, when able, by skills instead of certificates focuses on the true day-to-day demands of the business. “People are being hired in ways that are a little bit more attuned to the needs of the organization,” said Vardeman.

Attracting the Next Generation of Workers

As the population continues to age, so does the workforce at Memorial Hermann. Therefore, Knowles and her team must think ahead, providing employment models that are attractive to younger generations who may not want to spend their entire careers working difficult “bedside” roles, while also providing part-time flexible opportunities that might entice those of “retirement age” who still want to work, just not every day. The organization also provides a comprehensive benefits package that includes on-site personal counselors, elder care benefits, and retirement plans. 

To keep her employees of all different generations motivated, Knowles always goes back to the mission and value of the health system’s work. “What I try to do all the time is remind people that this is a noble profession. I’m famous for saying, ‘We’re not making peanut butter here, folks. We’re taking care of people’s lives for generations to come.’” 

Katie Chambers is a freelance writer and award-winning communications executive with a lifelong commitment to supporting artists and advocating for inclusion. Her work has been seen in HuffPost and several printed essay collections, among others, and she has appeared on Cheddar News, iWomanTV, On New Jersey, and CBS New York.

(Photos by Annie Mulligan for From Day One)

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