PITTSBURGH — David Holmberg explains that his first week on the job as the CEO of Highmark included a private lunch with the then-PNC Financial Chair Jim Rohr at the iconic Duquesne Club in the heart of the city.

The setting, which had him surrounded by rich paneled walls and the 19th-century paintings that once hung when men like Andrew Carnegie, John Rockefeller, and Andrew Mellon brokered deals, led Holmberg to believe that Rohr was about to discuss something significant, and he needed to prepare for it.