Cooper University Health Care announced Monday that chief executive Adrienne Kirby will get the additional title of executive chair and that Kevin O'Dowd and Anthony Mazzarelli, a physician, were named co-presidents of the Camden health system, with responsibility for day-to-day management of Cooper. The changes are effective immediately.

Kirby, who joined Cooper in 2012, will work with Cooper's board of directors, led by chairman George E. Norcross III, on ways to continue Cooper's growth.

O'Dowd, at Cooper since 2014 and a veteran of the Christie administration, has most recently been Cooper's chief administrative officer. Mazzarelli has been at Cooper since 1999, most recently as chief physician executive.

Cooper last year had a very small operating income of $290,000 on revenue of $1.2 billion, but the nonprofit said that included a $34 million one-time expense for a new Epic revenue-cycle billing system. Excluding that cost, Cooper's operating margin was 2.9 percent, according to preliminary financial statements.