BETSI Cadwaladr University Health Board has paused hiring a new chief executive.
Despite offering a salary of £225,000, the special measures health board were unable to fill the role.
A "further intensive search" will recommence in the near future.
BCUHB, which is Wales' largest health board with 19,000 staff, has had four chief executives in the past four years. It serves a population of 700,000.
The last leader was Jo Whitehead. Mrs Whitehead brought forward her retirement plans due to family circumstances and left her post on December 23 2022.
Dyfed Edwards, chair of BCUHB, said: “Our campaign to recruit a new chief executive did not result in us making an appointment and a further intensive search will recommence in the coming months. This is a critically important job and it is vital that we appoint the right person to build the positive culture that will help to guide the organisation into a brighter future.
“In the intervening period, I’m pleased that Carol Shillabeer will continue in the role of Interim Chief Executive. Carol has extensive experience in Chief Executive and clinical leadership roles in NHS Wales and she is working hard with colleagues across the health board to ensure that we achieve a period of stability, while making progress in addressing some of our key challenges.”
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A job advert for the chief executive post described the role as a "unique opportunity".
It went on to say: "A unique opportunity awaits an outstanding leader whose personal values, strategic vision and excellent track record can positively impact the health and wellbeing of the people of North Wales.
"The Health Board has a complex history and requires an exceptional person to lead it through a difficult and challenging time. It needs a CEO who can inspire, motivate and guide the executive team, clinical and managerial leaders and their staff to be the best they can so that together they can thrive in a culture and ethos that is delivering the best outcomes for patients."
BCUHB was put into special measures for a second time in February. This was due to "serious concerns about performance, leadership and culture".
The chair, vice chair and independent members of the board agreed to step aside.
Ms Shillabeer was previously chief executive of Powys Teaching Health Board. She took up the interim chief post on Wednesday, May 3.
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