Burwell, who received strong support from members of both parties, including a glowing recommendation from Sen. Tom Coburn, R-Okla., was repeatedly asked by Republicans to commit to responding to inquiries from Congress and explain whether she would make further changes to the implementation of the Affordable Care Act.
The line of questioning was a reaction to outgoing Secretary Kathleen Sebelius, who Republicans accused of delaying when asked to respond to requests for information, and not at Burwell, who was the recipient of broad bipartisan praise.
"I said on the day you were nominated, you have a fresh start with Congress and the public, but you're going to have to do things different than [Sebelius] has done," said Sen. Chuck Grassley, R-Iowa. "We can be very cordial today, but if you want to change the relationship your department has with Congress, you're going to have to change the by-any-means-necessary culture."
Burwell not only committed to responding quickly, but urged senators to reach out to her directly.
"I hope that you would pick up the phone and call me," Burwell said.
"Transparency and accuracy are the two things I want to do in a timely fashion, and you have my commitment on that," she added later.
But while making repeated overtures to work with Congress, Burwell also refused to promise there would not be further adjustments to how the Affordable Care Act is implemented.
"One of the things I think is important is how we do commonsense implementation that works for people," she said. "The system needs to work for individuals, it needs to work for insurers and actually providers as well."
Burwell was unanimously confirmed last year to serve as the director of the Office of Management and Budget. She served as president of the Walmart Foundation and was the COO and president of global development for the Bill and Melinda Gates Foundation.
She is expected to be easily confirmed in the coming weeks.