In an era of increasing demand, constrained budgets, and workforce pressures, imaging leaders are challenged to deliver more without additional resources. This presentation offers a practical, business manager–driven perspective on leading through these limits by focusing on resilience, resourcefulness, and efficiency. Drawing on real-world examples from imaging operations, this session highlights how strategic approaches such as contract optimization, leveraging in-house biomedical engineering, supply standardization, and capacity optimization can generate meaningful cost savings and improve system performance without compromising patient care. Attendees will gain insight into how the business manager role serves as a critical bridge between financial stewardship and operational success—identifying hidden opportunities, reducing waste, and enabling smarter decision-making. This session moves beyond theory to share tangible strategies and results that imaging leaders can apply within their own organizations. Learning Objectives By the end of this session, participants will be able to: Identify practical strategies to achieve cost savings and cost avoidance in imaging operations through contract optimization, supply management, and service delivery models Describe the value of leveraging internal resources, such as in-house biomedical engineering, to reduce external costs and improve equipment uptime and operational efficiency Understand the strategic role of the business manager in connecting financial data with operational decision-making to drive performance improvements Apply a resourcefulness mindset to uncover hidden inefficiencies and implement sustainable changes in constrained environments