President Barack Obama nominated Marilyn Tavenner, the second-in-command at the Centers for Medicare & Medicaid Services, to succeed the outgoing Dr. Donald Berwick after he steps down Friday.

Tavenner has been in the second chair at CMS since February 2010, serving as principal deputy administrator and COO. She will keep her current positions but serve as acting administrator during the Congressional confirmation process.

A former secretary of health & human resources in Virginia, Tavenner’s nomination is expected to be confirmed by Congress – unlike her predecessor’s, which was blocked by Congressional Republicans looking to thwart Obama’s health care reform push by any means necessary.

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"Before entering government service, Ms. Tavenner spent nearly 35 years working with health care providers in significantly increasing levels of responsibility, including almost 20 years in nursing, three years as a hospital CEO and 10 years in various senior executive level positions for Hospital Corporation of America," according to a statement from the White House.

The administration has been quiet about the appointment since its stealth announcement last week, just before the Thanksgiving holiday, perhaps hoping to avoid another donnybrook over the nomination.

Sen. Orrin Hatch (R-Utah), the ranking Republican on the Finance Committee, promised to pore over Tavenner’s record but did not threaten to block her nomination outright.

"Any nominee to a federal agency with this much power and authority over the lives of millions of Americans must be carefully scrutinized," Hatch said in prepared remarks.

Unlike Berwick, Tavenner is known for her pragmatic management experience rather than for any controversial policies, according to the Washington Post.

Obama slid Berwick into the position in 2010 via a recess appointment after his nomination ran into a buzz saw of GOP opposition, thwarting Republicans who’d been champing at the bit to grill Berwick in public. Obama re-nominated Berwick in January, setting the stage for yet another partisan confrontation over who should have the job of implementing Obama’s signature health care reform law.

GOP senators attacked Berwick’s lack of experience in the insurance arena and years-old statements about the British healthcare system. The nomination fizzled after 42 Senate Republicans — two more than the 40 needed to veto Berwick’s confirmation — sent a letter to Obama asking him to withdraw the nomination.

Prior to Berwick, CMS had not had a permanent administrator since 2006, when Mark McClellan stepped down. Berwick’s last day at CMS will be Dec. 2.