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When a coworker showed Marilyn Bartlett that she made Fortune’s 2019 list of the World’s 50 Greatest Leaders, she initially thought it was a joke.

“I just accused him of being really good at Photoshop,” said Bartlett, the special projects coordinator for the Office of the Montana State Auditor.

But her skepticism quickly turned to tears of joy, she said, and everyone in the room got a hug.

“Even though these guys aren’t huggers, I made them hug me,” she said with a laugh.

Checking in at No. 13, Bartlett has joined the likes of Gates Foundation co-founders Bill and Melinda Gates, New Zealand Prime Minister Jacinda Ardern, former FBI Director Robert Mueller, Microsoft CEO Satya Nadella, Apple CEO Tim Cook and actor Michael J. Fox on Fortune’s sixth annual list of the world’s greatest leaders.

Selected by a team of Fortune editors, this year’s honorees include men and women who are “transforming the world and inspiring others to do the same.” Bartlett was selected for what she accomplished during her time as administrator of the Health Care and Benefits Division of the state Department of Administration, a position she held from September 2014 to June 2018.

“Bartlett helped save Montana’s state health plan from bankruptcy by demanding transparency from hospitals and doctors, then negotiating better deals,” according to Fortune. “Other employers are now clamoring to follow her lead.”

When Bartlett started in 2014, the state health plan was projected to be millions of dollars in the red by December 2017.

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“I took that position and dug in to try to figure out where the money was and what was going on,” she said.

As a result of Bartlett’s negotiations, she said, the state now reimburses Montana hospitals at a percentage above Medicare instead of an “arbitrary charge rate.”

“By the time she left, she turned it into a massive budget surplus,” said Kyle Schmauch, spokesman for the auditor’s office. “ … She played real hardball with the hospitals to get a more reasonable rate for their services.”

Bartlett has been traveling around the country to share the success she has seen through these and other efforts to fix the state health plan, she said, and several other employers are now following suit. In October 2018, her success story was featured in a ProPublica article co-published with NPR.

“I never intended for all this publicity,” she said. “I was just doing my job. I’m an accountant, and we dig into the data and we ask questions.”

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