NYC Health + Hospitals President and CEO Ram Raju, MD, will be giving up the post at the end of November, after nearly three years in charge.

Raju was first appointed in 2014 after running another large public system, Cook County Health and Hospitals in Chicago. He’s leaving in the middle of a five-year transition plan for the financially troubled system, which faces a total budget gap of $6 billion through 2020 and needed a $337 million cash infusion from the city this year.

“I step down feeling certain that the work we have accomplished over the last two and half years puts us on solid ground to build a stronger, more efficient and financially sustainable public healthcare system,” Raju wrote in a resignation letter sent to system staff.

According to POLITICO New York, Raju’s plan will continue under the new leadership, focusing on cutting the workforce in the system, enrolling more people in its health insurance plan, MetroPlus, and getting CMS to delay cuts in uncompensated care payments.

The Office of New York City Mayor Bill de Blasio praised Raju after the resignation became public.

“The administration is deeply grateful for Dr. Raju's service in developing and launching a transformation of Health + Hospitals that will ensure our treasured public healthcare system continues to provide the best in care to all New Yorkers, including our most vulnerable patients,” spokeswoman Aja Worthy-Davis said to the New York Daily News. “Our healthcare system will continue to be led by an experienced healthcare leader well-equipped to continue the work of modernizing public healthcare, making it more patient-friendly and efficient for all New Yorkers.”

Taking over for Raju will be temporary replacement Stanley Brezenoff, who ran the system from 1981 to 1984. He’ll be at the helm until a permanent CEO is appointed.