Jackson Health CEO to step down. Who will be the new leader?

By Michelle Marchante for the Miami Herald

Jackson Health System’s CEO Carlos Migoya is stepping down after more than a decade of leading one of the largest public health systems in the nation. Migoya made the announcement Thursday during the monthly meeting of the Public Health Trust, the governing body that oversees the Miami-Dade public hospital system.

“Jackson’s transformation has become some of my life’s most meaningful work,” the 75-year-old Migoya said. “By making opportunities for the world’s best nurses, doctors, therapists and other healthcare professionals, we have rebuilt one of Miami-Dade County’s public jewels and created a system well on its way to being a national role model.” His successor will be David Zambrana, Jackson’s president and chief operating officer, who has worked with Migoya for more than six years. The board unanimously appointed Zambrana Thursday as the future CEO of the taxpayer-funded hospital system, upon the recommendation of Migoya, instead of launching a national search. Both Migoya and board chair Amadeo Lopez-Castro III told the Miami Herald after the vote that they didn’t believe a search was necessary because of Zambrana’s work within the health system and his knowledge and involvement in the South Florida community. “Jackson is a very complex system,” Migoya told the Herald, noting that he believes “the biggest legacy” of any CEO is to identify the “right person” to succeed them. A national search, in Migoya’s opinion, means the CEO failed to find a successor. And the Jackson leader showed his full support for Zambrana in the meeting.

“He would be the most prepared leader in our 107-year-history,” Migoya said shortly before receiving a standing applause from board members and Jackson employees at the meeting.

Zambrana, a registered nurse and doctor of nursing practice, began his health career at Jackson Memorial working in cardiac surgery intensive care, trauma and pediatric intensive care. He came back to Jackson in 2016, when he left his job as chief executive at the neighboring University of Miami Hospital for the same job at Jackson Memorial Hospital. He is currently Jackson’s chief operating officer and serves on the board of United Way Miami, which he will chair later this year.

“I am deeply honored, excited and proud to have this opportunity to lead Jackson Health System — a place that has had a profound impact on me since I first walked through its doors 35 years ago as a nurse at Jackson Memorial Hospital,” said Zambrana. Migoya, who has led Jackson for nearly 15-years and is credited with saving the hospital system from financial ruin, will remain as CEO through the end of May. Zambrana will officially take the reins June 1 and oversee a hospital system with more than 15,200 employees. “The magnitude of this moment is not lost on me. … I will honor, uphold and safeguard Jackson’s sacred mission, knowing that this health system is a place of hope and healing for everyone — regardless of their life circumstances,” Zambrana said.

Migoya said he plans to remain involved with Jackson through an advisory role and as an ambassador for the health system. His announcement came the same day the board gave him high marks during his annual performance review. Migoya received perfect scores in his evaluation from all board members and was praised for his leadership and judgment, both in the anonymous evaluations and during Thursday’s meeting. “What distinguishes Carlos is his remarkable capacity, as others have said, for building teams, not just competent teams, but great teams. Like any masterful quarterback, he understood that excellence emerges not from solo heroics, but from synchronized strength, shared sacrifice and strategic vision,” said Walter T. Richardson, chaplain with the Miami-Dade Police Department and a current member and former chair of the Public Health Trust. Miami-Dade County Mayor Daniella Levine Cava, who made a surprise appearance during Migoya’s review at the start of the meeting, also praised his leadership and “many, many years of outstanding service.” His leadership, she said, “really turned the tide” during some of the county’s recent challenges, including the COVID-19 pandemic, when hospitals were overflowing with sick patients, and the county’s reform efforts, done in partnership with Jackson Health, to improve jail conditions, including medical and mental health care and suicide prevention. Migoya, who was not in the room during the review, entered to a round of applause and was hugged by the mayor. She left before Migoya announced his plans.

Migoya’s plans to leave the CEO role comes after the board in 2025 gave him a hefty pay raise as part of a new two-year contract to make his salary more competitive with other CEOs that run similar not-for-profit health organizations. And he’s set to see another pay raise before he leaves, with a 3% pay raise in February, bringing his base salary up to $1.44 million. Migoya will be stepping down before the end of his contract, which was expected to run through June 17, 2027. Zambrana still has to negotiate his new CEO contract. “I never thought I’d be here this long,” Migoya told the Miami Herald last year, noting that the Jackson CEO position has now been his second longest role. “Ever since I got here, my number one job was always to find the right replacement for me.”

As Miami-Dade’s safety net hospital system, Jackson provides care to everyone, even if they can’t pay and don’t have health insurance. Jackson also serves as a teaching hospital through a partnership with the University of Miami Miller School of Medicine. Migoya, a retired banker with decades of experience in the banking industry, was hired in 2011 following a national search to help steady the financially wobbly Jackson. Before coming to Jackson, he worked for $1 a year as Miami city manager in 2010 to stabilize the city’s budget issues. In his first year as Jackson CEO, the hospital system produced a surplus of more than $8 million, its first since 2006. Jackson has since earned an annual surplus every year, including in 2024 when it faced one of its toughest financial hurdles in over a decade. The health system grew under his leadership and will soon open one of the largest ERs in the natio

It hasn’t been without challenges. One of the most recent ones: navigating the fallout of a long-running scheme by a former executive that bilked millions of dollars from the hospital’s nonprofit fundraising arm. Migoya said his time serving as Jackson’s CEO was the best way he could repay “everything this community and this country have done for me since I arrived from Cuba in 1961.” “Jackson’s best future is on the horizon,” he said.