Between her times in government, Burwell served as president of Walmart's charitable foundation focused on ending hunger, beginning in January 2012.

Following Clinton's inauguration, Mathews, working with Robert Rubin, helped establish the National Economic Council (NEC).

[12][14] She testified before a Senate committee during the Whitewater investigations regarding her search of Vince Foster's garbage and the fate of the documents she discovered.

[14] She was deputy chief of staff for policy, charged with the task of keeping the White House focused on its agenda amid the impeachment of Clinton.

"[7] Bowles resigned in 1998, at which point Podesta was named chief of staff, and Mathews moved to the Office of Management and Budget (OMB), where she took the role of deputy director under Jack Lew.

[12][14] In 2001 Mathews relocated to Seattle, Washington, to work for the Bill and Melinda Gates Foundation, the largest philanthropic organization in the United States, as an executive vice president.

[14][23] Mathews was involved in awarding grants to improve health outcomes in the developing world, including stopping the spread of HIV and other diseases and making contraception more readily available.

The board was also tasked with setting up a compliance program to fix a Medicare billing irregularity that had resulted in a settlement with federal investigators.

[4][dead link‍][27] In 2008, known as Sylvia Mathews Burwell following her 2007 marriage, she was named Obama/Biden Transition Agency Review Lead for the Federal Deposit Insurance Corporation.

She officially joined the Wal-Mart Foundation, which focuses on ending hunger in the United States, as the organization's president in January 2012.

[12] Burwell entered the job at a time when conservatives wanted to decrease spending and defund Obama's signature healthcare legislation, the Affordable Care Act, also known as Obamacare.

[16] On April 11, 2014, Obama nominated Burwell to be the next secretary of health and human services, succeeding Kathleen Sebelius, who had announced her resignation the day before.

[41] With an Ebola epidemic devastating West Africa, Burwell began holding daily meetings on July 28, 2014, as part of the efforts of the United States government, including the Department of HHS, to prevent the further spread of the disease.

[45] The plan included provisions to help U.S. hospitals become better prepared and to support global health initiatives aimed at containing the disease in Africa.

[46] Burwell and other Obama administration officials sought to assure the public that the American health system was prepared to deal with Ebola cases and that the chances of a full outbreak in the United States were low.

[48] Congress did not initially take action, leaving Burwell to direct the Department of Health and Human Services to reprogram $589 million in funds previously designated as part of the response to Ebola, to fight the spread of the Zika virus.

In response to Congressional complaints that the money was not being spent fast enough, Burwell informed Congress that without further funding, the CDC would deplete its budget to fight Zika by September 30, 2016.

[49] After Burwell moved funding from other HHS programs, Congress finally appropriated $1.1 billion to fight the spread of Zika in the United States.

[48] Burwell's tenure as HHS secretary began ahead of the Affordable Care Act's second open-enrollment period for healthcare insurance in November 2014.

[53][54] In July 2016, ahead of the 2016 elections, Burwell began touring, giving speeches on the success of the Affordable Care Act and its potential for the future.

[56][57] Burwell and the Department of HHS devised the "Coverage Matters" campaign to increase public support for the law and to boost enrollment.

[60] In 2020, Burwell was appointed by the Council on Foreign Relations to co-chair (alongside Frances Townsend) the Independent Task Force on Improving Pandemic Preparedness.

The Change Can’t Wait campaign has already made an incredible impact – creating four new and expanded research centers, eight endowed faculty positions, more than 170 scholarships, and more.