The pages of healthcare management journals are filled with articles stressing the importance of properly transitioning senior executives into new positions. Middle managers are integral to an organization's ability to further people in these positions, but they do not always get the attention they deserve. Middle managers play a vital role in the success of an organization by effectively and efficiently implementing the strategy set by senior management. The five focus areas that are necessary ingredients to help executives successfully find, hire and transition middle managers are: 1. Define the challenge. 2. Define the expectations. 3. Define the working relationship. 4. Identify a mentor within the organization to guide the new manager. 5. Hire an outside coach. Middle managers may possess technical skills, but success in a leadership role requires more than technical competence. It requires organizational communications skills, political and cultural sensitivity and the ability to get things done through other people.