Celeste Rouleau sees herself as the mayonnaise in the tuna salad – the component that holds everything together.

“I’m behind the scenes, really working with the team to make the team successful,” she said.

Rouleau, pediatrics practice manager at InterMed, works in a high-demand profession that marries medical expertise with management skills. It takes a special kind of person to do it well.

“You wear many hats,” she said. “You have to be authoritative but tactful.”

That’s in large part because the people she manages are accomplished medical professionals in their own right. Rouleau oversees a staff of 45 doctors, nurses, nurse practitioners, physician assistants and clerical staff members.

Like most managers in the health care field, Rouleau worked her way up through the system as a practitioner herself. She began as a registered nurse, working many years in a hospital. During that time, she always seemed to gravitate toward leadership roles.

Rouleau said that while taking care of sick people remains her passion, she discovered along the way that she has a knack for leading a team.

“A good manager has that certain skill set,” she said. “You have to love people, and you have to love communicating with teams.”

It is challenging work, she said. Being a health care manager requires constant education as various changes are spurred by government, technology and the insurance industry. And managers in the medical field spend much of their time dealing with more mundane issues such as paperwork, billing and reimbursement from insurance providers.

“Sometimes it’s not, unfortunately, all about medicine and seeing patients,” Rouleau said.

Still, it is a satisfying career for anyone who chooses to take on the challenge.

“It’s really fulfilling,” she said.