For Mary Elcano, change has been the norm. Soon after coming on board as general counsel and corporate secretary at the American Red Cross in 2003, Elcano became heavily involved in restructuring the entire organization. “If you were to ask me in the 10 years in January I’d been with the Red Cross what the most consistent activity has been, it’s been massive change,” she said.

The organization, with $3 billion in revenues, was plagued with disagreements over management, particularly at its 700 chapters, and concerns from donors about how their money was being spent.

The Red Cross sliced its 50-member management board by about two-thirds, instituted a corporate-governance program and put its president and chief executive officer in charge, Elcano said. The restructuring involved ­legislative reform — because the Red Cross is chartered by Congress to fulfill provisions of the Geneva Convention — that required President George W. Bush’s signature.

Then, in 2007, Elcano took over as acting president and chief executive officer after former head Mark Everson resigned amid revelations of a personal relationship with an employee. She returned to her general counsel post in 2008, by which time the recession had caused a spike in the organization’s deficit. Meanwhile, restructuring continued at the organization’s individual chapters, now numbering 550, whose operations became centralized and consolidated.

As a result, since 2008, the Red Cross has laid off thousands of employees, most recently last year. All this while responding to some major disasters, such as Hurricane Katrina and the tsunami in Southeast Asia. Elcano said the most rewarding part of her job is assisting at the latest disaster site, handing out water bottles or supplies to people. But she’s also enjoyed the legal challenges inherent in embarking on such a major organizational overhaul. “It was a massive amount of brain power and legal work to get it all straight and get it right,” she said.