There are many ways to add value and have an amazing career as a CFO. In this episode, Denise W. Marks, CFO of the CareQuest Institute for Oral Health, shares her insights on CareQuest’s mission-driven focus and digital strategy. She also discusses the importance of embracing diverse opportunities, not being afraid to ask for help and finding your own unique way to add value as a CFO.
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I’m looking forward to the guest because this is the first time I’ve had a guest that I’ve known for more than a year or two. Denise and I met, as best I can tell, in the 1990s. I’m not exactly sure, but we were both part of a local CFO network. My guest is Denise Marks. She’s the CFO of the CareQuest Institute for Oral Health. As I said, I’ve known her for more than a quarter of a century. Denise, welcome to the show.
Thanks, Jack. It is great to be here. Thank you for asking me to be here. You’re dating us a little bit. I’m not sure it was that long ago, but I won’t hold you to it. Yes, we’ve known each other for a long time.
2019, I remember HDFE. It’s interesting because someone from your comms team reached out to us and was unaware that we’d known each other for a little bit. I’m like, “That’s the same Denise Marks.” Anyway, it’s great to see you and great to have you on the show. I want to explore your career path and a few other things, but before we get into that, can you tell us a little about CareQuest from the 10,000-foot view?
CareQuest Institute for Oral Health is a large nonprofit focused on improving the oral health of all. We do that through a number of philanthropic activities and programs, including research and education, policy and advocacy and grantmaking, among others. We also have a for-profit affiliate, CareQuest Innovation Partners, which serves as our innovation and impact investing arm. I oversee that as well as serving as CFO of the entire enterprise.
That’s exciting. We’ll discuss that a bit, as far as I know, you’ve never worked in the nonprofit sector until this role. We’ll explore that change and what that was like. Before we get into a lot of that, I’d like to just ask a little about your early years. Where did you grow up?
I grew up in a suburb of Philadelphia in a town called Rosemont, which is right near Villanova University. I’m one of five kids. I’m number four of five and lived in Pennsylvania, went to college in Pennsylvania and then fell in love with Boston. I always loved Boston and found my way here and I’ve spent my whole career in the Boston area.
In sporting events, that’s a natural rivalry, Boston and Philly. Do you find yourself torn, or are you taking the Boston side at this point?
The way we’ve looked at it is that if the Eagles and Patriots might be playing in a certain Super Bowl, I cannot lose.
That’s a fair way to look at it. It’s one of the best sports rivalries because both fan bases are fairly obnoxious.
No, it’s true. It’s fun to be an Eagles fan when the Eagles are winning. It’s fun to be a Pats fan when the Pats are winning.
You get double your chances of being a happy sports fan. After high school, you studied economics as an undergrad and got a master’s, I believe, in accounting. I’m curious, what about economics and the business community generally was attractive to the seventeen-year-old version of Denise?
I was a finance major undergrad with a minor in econ. In high school, I started working at Merrill Lynch part-time in addition to working at a pharmacy chain that’s no longer around. I spent a lot of my time, in addition to attending school and participating in sports, working. I enjoyed the environment at Merrill Lynch, working with people of all different levels and getting exposure to investing at a very early age.
Early Career
That sounds like a great thing. You graduated and you started your career at PWC.
I did. Before that, I worked in a commercial bank in New England, then joined Price Waterhouse. I worked in commercial lending with a bank that has gone through multiple iterations, but it was Bank of New England at the time. I am dating myself for those from New England who remember the Bank of New England but lived through the real estate crisis and the bank being taken over by the FDIC, etc. That’s when I decided to return to graduate school and ultimately earned a master’s degree in accounting and an MBA. That’s when I joined Pricewaterhouse.
“Living through the dot-com boom and bust was truly an experience. I am grateful for having that opportunity. It was like dog years. Every year was a dog year.”
Makes sense. You worked for one of the most fascinating companies, but I realized that younger people may not be familiar with CMGI. That must have been the ride of a lifetime. I’m just surprised people like academics haven’t written books about it.
I know I am, too. It was an unbelievable ride, as you said; living through the dot-com boom and bust was truly an experience. I am grateful for having that opportunity. It was like dog years. Every year was a dog year. What I learned, being part of the Internet boom and bust, was crazy. It was crazy to be at the start of online shopping. I remember telling my partners when we were looking at a company called Furniture.com. I said to my partners in an investment committee, “I will never buy furniture online.” I said that statement. “I will never buy furniture online.” It’s remarkable to consider how our shopping habits have evolved. A lot has changed from the start of the internet, but it was fun to be part of that journey.
I buy pretty much everything online other than food. I’ll buy some foods online, but I just still grocery shop. Not that I buy a bunch of suits anymore, but when I do, I like to go in and try them on. I don’t want to trust it. Probably at some point, I’ll be the only one doing that. Everyone will be getting suits online and bringing them to their tailor. It must have been quite a run. Within the SV [Health Investors] family, which I think is where you and I met for the first time, you had a great one there before CareQuest. I’m curious, you had some wonderful experiences. What are some of the lessons that you learned along the way and maybe some of the most critical mentors you’ve had that shaped you for the current role?
I’ve been very fortunate to have amazing mentors over the course of my career. I remember one of my first mentors at the Bank of New England. I think she was the only woman EVP that existed at the bank. She was an older woman and she was a rock star. She gave me lots of sage advice about being a woman in a largely male-dominated industry like banking. I think of her often.
She was probably my earliest, one of my earliest mentors at the start of my professional career. As I said, very fortunate to have had amazing mentors throughout my time at PWC. Through every position I’ve held, I’ve had both great internal advocates and mentors, and I’ve found people in the industry whom I respect and seek advice from, forging amazing personal and professional relationships.
The Importance of Mentors
That’s wonderful. When I wrote the book Secrets of Rockstar CFOs a few years ago, which it was amazing how quickly it became outdated, but just that the roles changed so much in the last five or six years. Everyone I spoke to, and I spoke to some elite CFOs, they all had a mentor. It wasn’t necessarily someone in the world of finance and accounting, but they all said, “It’s such an underrated thing that you learn more from your mentor than you do from anyone else except your parents, maybe.”
It’s true. Many of my mentors have been men. Finding that connection and that person who’s willing to take you under their wing and just be there as a guide and a sounding board is always huge. I try to do that myself and always have, as I’ve grown in my career, making sure that I’m paying it back and paying it forward.
I was going to ask you about that. Given the positive impact that mentors have had on your career, are you presently or do you frequently mentor other up-and-coming professionals?
For sure, all of my roles and particularly at SV [Health Investors] because I spent a good chunk of my career there. I’ve had the good fortune of serving as a mentor for a number of my direct staff and even others that were not my direct staff, but others in the firm. I keep in touch with many of them. It’s so important to have that person to help you navigate some of the bumps in the road, which inevitably happen.
Misson-Driven Focus
That makes a lot of sense. I want to ask you a little about your current role. Before we do get into it an obvious question, at least to me is, what a wonderful mission it has. What was it that was compelling to you that made you give up the traditional corporate career for a mission-focused organization?
I left SV at the end of 2019 after a great ride there. I adore my former partners and colleagues. I still am very close to many of them. For a variety of reasons, it was time for me to move on. My plan was to take a break, maybe six months to a year, and figure out what I wanted to do when I grew up. To be honest, I was not hunting for this role. Funny enough, it connected through more than one thing, where multiple people said, “You have to meet this organization” or “you have to meet this person at this organization.” The dots connected, and the more I learned about what we were doing and that the organization was at a major inflection point, I felt like I couldn’t say no. It was four years last September that I’ve been with CareQuest.
I vaguely recall when you joined. It goes by quickly. I’m curious now, again, being with a mission-focused organization, does that change how you approach your role as the CFO?
Not at all. I would say the activities that the organization is engaged in are slightly different than what I’ve been involved with previously, but I like to build things. Every time I joined an organization, whether it was CMGI Adventures or CareQuest or SV, it was always starting on some new major inflection point for the organization. At CareQuest in particular, it was going through a major reorganization. We were looking to build the team to build our operating capabilities separate from a former affiliated company that we owned. The affiliated company had done all the shared services.
It was the opportunity to build a team, build systems and drive the strategic direction, including building a leadership team from scratch. I was the second member of the executive team after the CEO. It was a startup, and I like the entrepreneurial nature. We are fast. We are not a sleepy nonprofit. We are doing many different things and moving at a very fast pace. We were 36 people when I joined, and now we’re over a hundred. Pretty dramatic growth in a lot of ways, not just personnel, in that timeframe.
That’s fantastic. I wanted to get your philosophy on building a team because I know as long as I’ve known you’ve always taken a lot of pride in the people who’ve worked for you. What is your approach to building a team in finance and accounting? You probably have tentacles outside of the F&A world as well.
Particularly in a small-ish company, my philosophy is that I want field players. I want people that can think strategically but aren’t afraid to roll up their sleeves. They’re willing to wear lots of hats. You’re moving at a fast pace. People who are willing to take on new challenges and grow and be challenged in a good way. Those are the types of people I want on my team. It cannot be stagnant, even in a nonprofit like CareQuest Institute. We are tackling big challenges. We need people that embrace that. Sometimes working at a startup or a rapidly growing company, you need to embrace the chaos that exists and make sense out of the chaos. That’s the fun part, I think. Finding people that think and operate that way is the key.
If I were to give Amara a call and ask what your leadership approach was, would she say good things?
I hope so. I think she would. She worked for me a gazillion years ago at PWC. I’m fortunate to just have brought her on in the last six months as my controller here.
She’s great. She audited me.
There you go.
One thing that my members ask me all the time, and I’d love to get your perspective on this, is how do you build a relationship with the CEO? I know you have one of the elite CEOs at CareQuest, and you’ve worked with others as well, with different personality types. I’m just curious as a CFO, how do you build that strategic partnership with the people? I’ve recently heard that many people are referring to CFOs as the deputy CEO. You are the right-hand person to the CEO, but what’s the magic there?
It is being a strategic business partner and thought partner, and the ability to tackle tough and fun things together— whiteboard or brainstorm or think about the risks and opportunities of what you’re embarking on. I’ve had the joy of being that strategic thought partner, and strategic CFO, in all of my roles since since I left PWC in the late ‘90s. It’s super rewarding. It’s super challenging. That’s the real value of the CFO, in my view.
Getting the finances right and the accounting piece is fine, but it’s the strategic things, whether it’s making an acquisition, making a decision about a divestiture or something else. I’ve been through those at CareQuest as well. I think every CEO also comes from different backgrounds and experiences, and they might not be an operational CEO or they might not be a financial CEO. The balance of what each of you bring and leveraging those skills is what I found not only rewarding for me, but the most powerful role of a CFO can perform.
Oral Health
One thing that intrigued me when I was prepping for the call is the quality of research that your organization does. In particular, I saw something called, “brushing up on oral health” and then the case for expanded health innovation and investment. Could you share some insights from that report and perhaps others that you think might be interesting to our audience?
At the Institute, we publish a ton of research. Data is what we view as one of our biggest assets. We have an amazing data analytics and insights team that we leverage to publish a lot of amazing research. As we think about investing in oral health, we believe there’s a unique opportunity. Not only is it a huge market, but a lot of typical investors have felt it [was] sleepy or maybe that all you can do in dental or oral health is DSL roll-ups. There’s a lot of innovation happening. As we think about the connection between oral health and overall health, whether it’s diabetes or cardiovascular disease, those connections are real.
Publishing the data shows the connection and the importance of chronic disease management and health systems— ecognizing that the mouth is part of the body. Not just the payers but also investors recognizing that there’s a huge opportunity. As we think about AI, as we think about a whole bunch of different aspects to improve the quality of care and reduce the total cost of care, there are some unique opportunities. I think we’re at this inflection point. We worked with PitchBook on one report talking about the investment in oral health and why there’s a real opportunity. We also did another report with Rock Health, also talking about why oral health matters and why it’s something we cannot ignore.
It’s interesting to think of it as a hot investment opportunity because I remember my dentist. the industry didn’t seem to change from the time I was four until maybe my 30s. I had a dentist who was 102 years old or so he seemed to me at the time. It just didn’t seem like a dynamic environment, but it in fact is quite dynamic.
I think you’re right. It’s been that way for many dentists, including probably the one you’re referring to. The teaching of dentistry has not changed since it was founded, but now we are starting to see a ton of innovation and not just in practice management software or other opportunities, but you can think about, like I said, AI and voice recognition. The ability to do things in a more efficient way and focusing on patient outcomes versus just charging for your cleaning or whatnot.
I think that the research you talked about is just amazing, but I want to talk a little about the company itself. I’m curious, obviously the company’s growing and doing well, and yet you’re a CFO. You’re always looking ahead a little bit. What do you think some of the biggest challenges and opportunities facing CareQuest for the next few years are?
One of the opportunities is on the data side. I mentioned it earlier. We have a large database and various data partnerships. We strive to continue proving that we can reduce the total cost of care and improve patient outcomes by integrating medical and dental care. That’s a huge opportunity for us. As we look at expanding our data partners, who we work with, and what types of data we focus on— medical, dental and social.
That in my view, is one of our biggest opportunities. Through our CareQuest Innovation partners, the ability to continue to innovate in the industry and look for unique investment opportunities is also important. Those are two of the big things. We’re also looking to transform an industry and look at major systems changes. We advocate for expanded benefits, particularly Medicare and Medicaid. We’re doing a lot of great work, but certainly, there’s lots of opportunity as we move forward.
Indeed, it sounds like it. I’m always curious, unless you’re that one in-100 company where the CEO is a former CFO, you’re probably the only financial expert on the leadership team. You have a unique role in making sure that the financial strategy and the strategic plan are in alignment. How do you do that in this environment, again, with the added thing that you’re you are a little bit mission-focused? Which doesn’t mean not financially prudent. It just means slightly different objectives.
We don’t have shareholders, but we are a public charity. We are beholden in this case to the state of Massachusetts. We have to be good stewards of our capital. I wear that hat with great pride and intention. As I think about how to invest our endowment and make sure that we’re maximizing our investment returns to be able to fund all of our work, that is always top of mind for me. Making sure that we’re doing it in the most efficient and impactful way toward executing on our mission. Sometimes we have to make hard choices, but how we drive forward our strategic priorities and how we measure the impact of those is where I am focused.
CareQuest’s Digital Strategy
That makes sense. You mentioned earlier how innovative the company is and it’s always pushing the envelope and transforming industries. Sounds hard, to say the least, but I’m curious, that’s probably not possible without a thoughtful digital strategy. I’m curious, how do you use generative AI and other technologies, not only in finance and accounting, but to give the overall organization a competitive advantage— to make it the most impactful organization it can be?
There are so many different facets to our organization. Collaboration is key. How do we make sure that there’s good data, there’s good communication and impact is measured? That is not easy. Depending on the team, you look at it in different ways but even on the financial side, we went through a new ERP implementation. We just went live a little over a year ago and integrated our grants tool with it.
We have real-time progress on who’s in our pipeline for grants and then where is it in the approval process. And that our grantees can be paid timely. It used to be a very manual process. It doesn’t sound super sexy per se, but these little things make a big difference in allowing you to free up time from things that are labor-intensive or manual. That’s where we’re focused as we continue to advance. We just implemented a new planning and forecasting tool that we’re finalizing now. We’re always looking to advance and leverage technology, both to minimize risk, minimize errors and create efficiencies and automation.
It makes sense because I have a friend, who owned a barbershop and like probably the least digitally savvy, the business that needs the least digital strategy out there. Men’s barbershop, you just come, you tell some of your inappropriate jokes and you got the guys here. With COVID and safety features and stuff like that, he had to innovate. If a simple business like that, and he’s a shrewd guy, and he’s probably well ahead of the curve in his industry. If he’s innovating, then every company is using digital technology to change.
I have a question. I wouldn’t call it personal, but when you worked at SV, not exactly an industry that was regulated that I know of, and maybe I’m mistaken on that but you the investment industry, it’s a little different. You’re working now in an industry that’s pretty tightly regulated. You mentioned that you’re beholden to the Commonwealth of Massachusetts. How do you deal with that from a financial perspective? How do you stay ahead of the curve on all of these regulatory challenges that you’re facing?
I have amazing team members and an amazing chief legal officer who understands the regulated business. We also own an insurance company in Massachusetts. There are several different regulatory regimes that we must comply with. Even HIPAA, people wouldn’t think about that necessarily, but we have the data I mentioned. We need to make sure that we’re HIPAA compliant and that we have privacy and data compliance with a whole host of regulations. It’s wide, but we make sure that we have great counsel both inside and outside. We have amazing training. We’ve have tools and regular training to make sure that all of our colleagues understand the environment in which we operate.
The CFO Revolution
That makes sense. I wanted to shift gears a little bit and talk about the CFO role or generally of financial leadership. To me, it went through like an evolution from around the time you and I first became a CFO it was largely the old-school finance and accounting and cost controls and whatnot. It slowly and steadily became strategic and leadership and communications. With COVID, I often say that the evolution became a revolution. What do you see as the direction of the role of the CFO in the next few years.
COVID changed a lot for all of us. I look at even just the composition of our employee base. We are now in almost 30 states for a small company. We have employees in that many states. That creates a lot of complexity and challenges with respect to hybrid and remote work, continuing to motivate people, making sure that, to your earlier point, the tools and technologies foster that collaboration, even in this continued virtual reality that we find ourselves in. Crystal ball, AI is probably one of the biggest opportunities, but also challenges us. How do we use it? How do we make sure we understand what it’s used for and why? That we’re using it in the right ways.
I think that will be in the next couple of years one of the biggest opportunities as AI and machine learning continue to evolve. I see that even in the companies we’re investing in, whether it’s teledentistry or AI-driven diagnoses, AI is not removing the role of the human, but it’s expanding the capabilities and taking us to new heights. I think that’s probably the biggest thing I see on the horizon.
That sounds good. One of the things I want to do with this show is change the perception that other people have about CFOs and finance and accounting professionals generally. I like to ask people about a fun fact or a favorite joke or whatever. You have one of the best fun facts of anyone I know. I’m just going to allow you to share that with us.
I guess my fun fact and claim to fame was I was an extra in a movie with Tom Cruise. This was many moons ago, but it was a movie called Taps, and it was filmed near my hometown. I got to join the Screen Actors Guild and say all four words and it was a ton of fun. I’ve had many weeks of filming for a couple of scenes, but it was pretty cool that my parents let me do that and miss school. I got to meet Tom Cruise and he came over to my family’s house on Mother’s Day for a brunch, because he wasn’t anybody. This was before Risky Business.
He wasn’t famous at that point. I know the movie. If I were to get the movie, are you in the closing credits?
Probably.
That’s something I would know.
I don’t know. I’ve never fact-checked that. I’m in a couple of different scenes. I’ll challenge you to find me.
There are going to be 5,000 people fact-checking that once this episode is released. That’s great. Another thing that’s underrated, but every elite CFO I know discusses it, is the importance of work-life balance. I know for you because you have a full-time job for this growing, wonderful organization. You’re on four boards of directors. As long as I’ve known you, you’ve always done a lot of community service type of work. You have a lot going on. How do you find time for other stuff?
I do find time. I have two girls. One is almost 24 and the other one’s a freshman in college. Certainly, throughout my whole career, I was juggling work-life balance, family commitments and all that good stuff. I was fortunate that I was able to do that. It is a juggle and it is about choices. I’ve had to pare back some of my boards. I’m focused on the portfolio company boards that we’re invested in, as well as a couple of key nonprofits.
I also serve as a strategic advisor on Northeastern’s Impact Fund and a couple of other things. You have to be picky and choosy. Your time is limited, as much as we like to think it is not. You have to do things that bring you joy. Some things you have a choice over, and others you don’t. The things that you do, they’ve got, in my personal opinion, they have to bring me joy. I don’t want them to be a grind. I choose to do things that I can add value and that add satisfaction. That’s always been my mantra— when it’s not fun anymore, it’s time to move on.
“Many people believe they must have a defined path and pursue a specific type of company or career. It may not happen that way. Opportunities will present themselves. Keep your eyes wide open and don’t be afraid to take risks.”
That’s a great philosophy. We’re only here for so many years, so make the most out of them. I’d like to conclude. You had such great success in so many different companies, but is there some advice that you could impart to what I frequently call the next generation of CFOs and those who are maybe they’re in their first CFO role or they’re on the cusp of getting things that they should be thinking about as they plan their own career paths?
A couple of things is to take advantage of what is put in front of you. Many people believe they must have a defined path and pursue a specific type of company or career. It may not happen that way. Opportunities will present themselves. Keep your eyes wide open and don’t be afraid to take risks. I did that with CMGI adventures and everything along my career path.
The other thing I would say is don’t be afraid to ask for help. There are so many people out there in your shoes and those who have walked in your shoes who can share advice and wisdom. Be that bang your head against the wall thing. Even in the networks that you and I talked about, whether it was a high-tech financial executives network or any other networking group, there are people out there who have been there, done that or have the same questions you do. Do not be afraid to ask.
That makes all the sense in the world. Denise, I know you have a lot going on. You’re busy. I certainly appreciate you taking the time to join us. I’d just love to give you the final word, anything that you’d like to share with the audience.
There are a ton of different ways that CFOs can add value and have an amazing career. Many different paths. Embrace the journey, have fun on the ride and it will all work out.
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That wraps up this episode of the Secrets of Rockstar CFOs. A huge thank you to our sponsors, Planful and the CFO Leadership Council, for their amazing support. Don’t forget to subscribe, leave a review, and visit us at RockstarCFOs.com. Until next time, rock on.
