Dawn Bulgarella, MSHA, CPA, has led UAB Health System since 2022. As chief executive officer, she oversees a 16-hospital system that includes UAB Hospital, community hospitals throughout the state, and what is now known as UAB St. Vincent’s, the revered system of regional medical centers acquired by UAB in November 2024.
With annual revenues approaching $8 billion and a commitment to providing quality healthcare and compassionate service to all, the UAB Health System is among the largest and most respected academic medical organizations in the country. It seems fitting that it would be led by Birmingham’s own resourceful native daughter, a John Carroll Catholic High School graduate and UAB alumna. Her trajectory was shaped by an innate talent for numbers, an aptitude for both hard work and adventure, and a deep appreciation for her community of mentors, colleagues, and family members.
UAB President Ray L. Watts, M.D., knows something about leading an organization as an alum in one’s own hometown; he grew up in Birmingham, graduated from West End High School and earned an engineering degree from UAB. As UAB’s longest serving president, who also served as senior vice president of Medicine and dean of the Heersink School of Medicine, Watts knows what Bulgarella’s extensive experience and steady presence mean to UAB Medicine.
“Dawn is ideally suited to lead UAB Health System based on her proven leadership and extensive experience in healthcare, but more than that,” Watts said. “As a Birmingham native who earned her master’s in health administration at UAB, she knows and loves this institution and this community. Dawn's deep sense of caring, compassion, and commitment to giving back to her community informs her outstanding leadership, and we are very fortunate to have her at the helm of our Health System.”
When Bulgarella first set her sights on UAB, however, she didn’t see it as a career opportunity or even as a place of higher learning, though it would become both for her over time. She saw it first as a playground, one in which she could lead a tiny band of kids who ran freely in the underground tunnels in the basement of UAB Hospital.
What’s around the next corner?
Born Dawn Brasher, the future executive attended elementary school at St. Paul’s Catholic School in downtown Birmingham in the early 1970s. As the second oldest of six children with parents juggling work and family, she and two of her siblings rode the city bus each morning and walked hand in hand from the bus stop to the school. They often carpooled home in the afternoon with another student whose mother worked at UAB as an administrative assistant. Sometimes they accompanied her to the hospital as she finished her workday, and when they did, the kids made sure to stay out of her business.
They escaped to the deep, dark service tunnels, where a maze of winding corridors spanned from building to building—under the city streets of the medical district—and allowed staff to transport supplies and tend to facilities in a functional, no-frills environment. The children found the tunnels liberating.
“We had fun by exploring, hiding, chasing one another—none of the things we should have been doing in a hospital,” Bulgarella said of the site that would become the best hospital in Alabama and the eighth largest hospital in the country. “The tunnels were probably scary, which is why I can still remember them so vividly. We must have been reasonably well-behaved because no one ever reprimanded us for it.”
For the afterschool explorers, it was the definition of freedom, a chance to unwind after the rigid confines of school. Eight-year-old Bulgarella and the other elementary school kids ran and chased each other, egging each other on to see what was around the next corner. She was often leading the way, staying mindful of what time they needed to report back and how they would get there. It became a proving ground for forging a path, tapping into curiosity and bravery, and encouraging the others who wanted to stay safely near the exit. The future CEO was a leader from the start.
Formative years: A daughter’s challenge
Thanks to a seating chart based on alphabetical order, Dawn Brasher would meet Joe Bulgarella in religion class. “We started dating as high school students and have now been married for 38 years, so that turned out pretty good,” she said matter-of-factly. He was headed to Tuscaloosa, and she wanted to go too.
“My parents were hard workers and pushed us to do our best in school. Unfortunately, with a family of eight, college tuition was not a financial benefit that they could provide,” she said.
After graduating from John Carroll, she worked full-time and started college by enrolling in a night class at UAB. With the help of a Federal Pell Grant, work study, and personal savings, she eventually enrolled at the University of Alabama as a full-time student.
Encouraged by a college advisor who recognized that she was “good in math,” she first studied electrical engineering, later changing majors to commerce and business administration. She went on to become a certified public accountant, launching her professional life as an auditor at Ernst & Young while also launching a new family of her own.
Just after she welcomed the first of three children, Bulgarella found herself in the midst of a heart-wrenching situation. Her father was diagnosed with leukemia. Despite the best efforts of his care team at St. Vincent’s Hospital, he passed away at the young age of 52, leaving her mother as the sole provider to three teenage children, Bulgarella’s younger siblings. Although her father had health insurance, it wasn’t enough to cover his extended hospital stays.
Bulgarella’s mother received a significant bill, and it was one she didn’t know how to pay. As the family’s designated business leader, 24-year-old Bulgarella represented her mother in an appeal to the St. Vincent’s benevolent committee, explaining the hardship and financial ruin that felt imminent. And then a miracle happened: The medical bill was waived.
“I have carried this appreciation with me for more than 30 years, and it certainly impacts my views of affordable healthcare for every person,” she said. “This is only one small story of the countless families that St. Vincent’s hospitals and physicians have provided care for throughout the years. Within UAB Medicine, there are hundreds if not thousands of similar stories. The mission of UAB and the UAB Health System is to care for all patients, without regard to financial status. The patient is at the heart of all we do, which made one aspect of our coming together with St. Vincent’s so seamless.”
Tackling the complexities on the way to the C-suite
Bulgarella joined UAB’s Health Services Foundation in 1993, working for the executive vice president on special projects. Later, she moved into clinical department administrative leadership roles, which provided her with skills in strategic planning, recruitment, operations, and finance.
Words of Wisdom & A Bit of Luck
“I had several high-school teachers that I looked up to that certainly helped me understand my academic potential. Combining that with the role my parents played in understanding the value of hard work and perseverance were the catalyst to pushing me towards college and ultimately towards a professional life.
“Through these experiences, I think I have an understanding of the importance of offering a helping hand to others, of providing career tracks at every level within an organization and meeting others where they are to foster genuine communication and connections.
“Over my lifetime, I’ve learned that you can typically do what you set your mind to do with hard work, positive attitude, some help or helpful advice from others and a bit of luck. Most things aren’t easy, but you don’t have to do them alone. I advise people to be open for advice and assistance on a daily basis and face challenges with a sense of optimism. As for luck—you just have to be in the right place at the right time and hope you recognize it.”
“These roles gave me an understanding of the business of academic medicine, how to work with faculty, and an understanding of the complexities of patient care,” she said.
She earned her Master of Science in Healthcare Administration from UAB’s School of Health Professions after being encouraged by a colleague, who recognized her potential for leadership. In 2014, she became chief financial officer of UAB Health System, proving herself adept at organizational strategy, financial management, senior-level recruitment, and negotiations. She was tapped to serve as president in January of 2022; she became CEO in July of that same year.
Today, Bulgarella serves on numerous healthcare boards and the board of directors of Protective Life. Recently named “CEO to Know” by Becker’s Hospital Review, she was also named “One of the Women Who Shape the State” by This is Alabama. She is a member of Leadership Alabama’s Class of XXXI and was appointed to the Alabama Workforce Board’s Executive Committee by Governor Kay Ivey last year. She serves as a mentor to numerous rising leaders while juggling the day-to-day nuances of directing the region’s largest health system.
“Being from Birmingham allows me to bring a personal understanding of the challenges and opportunities in our region,” Bulgarella said. “I’m deeply invested in seeing our city and surrounding communities thrive. I understand the cultural nuances and local needs, which helps inform the decisions I make and the strategies we put in place to serve people here,” she said.
“What I’m most proud of is our ongoing efforts to make healthcare more accessible, innovative, and patient-centered. We’re committed to improving not just the health of individuals but also the overall wellness of our entire region. It’s a privilege to be able to contribute to a healthier Birmingham, and I'm proud of how far we've come.”
For UAB’s own native daughter—one who once ran freely in the tunnels under the medical district—the C-suite is now her rightful home. Thankfully, her sense of adventure is still firmly intact.