Welcoming Siobhan Nolan Mangini: a conversation with Virta’s newest board member

We are excited to welcome the newest addition to the Virta board of directors: Siobhan Nolan Mangini! 

Siobhan brings over two decades of healthcare experience to her role. Currently, she serves as President and Chief Financial Officer (CFO) at NGM Biopharmaceuticals (NASDAQ: NGM), a biotech company focused on developing immuno-oncology treatments. Before that, Siobhan was the President and CFO of healthcare navigation company Castlight Health (NYSE:CSLT) and held healthcare roles at Bain Consulting and the Kaiser Family Foundation. 

With a breadth of experience scaling both private and public healthcare companies, Siobhan will be an invaluable asset to guide Virta through our next phase of growth—and reach our eventual goal of reversing diabetes in 100M people. 

Recently, CEO Sami Inkinen sat down (virtually) with Siobhan to learn more about her background, what attracted her to Virta, and what she thinks is the next big thing in healthcare. Plus, they discuss how Virta and other healthcare companies can survive in this tough economic environment, and what motivates her to get up in the morning.

Watch the interview here (full transcript below):

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Sami Inkinen

This is Sami Inkinen and co-founder of Virta Health, and I'm very excited that I'm here with the latest addition to Virta's board of directors. So I have Siobhan Nolan Mangini here with me, and I'm going to interview her, and get to know her a little bit. So Siobhan, thank you so much for joining me.

Siobhan Nolan Mangini

Thanks for having me, Sami.

Sami Inkinen

Very excited that you recently joined Virta's board of directors, but let's start with a little bit about your background. How did you get into healthcare as an industry to join?

Siobhan Nolan Mangini

Absolutely. And Sami, I'm so thrilled to be on the Virta board so thank you for having me. Healthcare has been something for me that I've been interested in since I was very, very young. I was one of those people, honestly, starting at six years old I probably had an interest in healthcare. Biology was my favorite class in high school. I volunteered to help map the human genome, like when I was a kid growing up in Seattle. And so every part of healthcare has actually been an interest to me.

In my career, I worked in management consulting at Bain and I did a bunch of healthcare work. I worked at a healthcare policy think tank, the Kaiser Family Foundation. And then more recently I've been an operator in two different healthcare businesses, one, Castlight Health where I was president and CFO. I had a bunch of different roles when I was there for over eight and a half years. And more recently, I am president and CFO of a biotech company that's focused on immuno-oncology in particular, which is very personally meaningful to me because my mom passed away from breast cancer when I was a teenager.

Sami Inkinen

That's a great description of your background. As we were looking for someone to join our board of directors who would have both private and public company experience, but specifically as an operator in the healthcare context. And you obviously bring that and much more, and we are very lucky and grateful to have you on our board.

Speaking of which, someone like you with that kind of a background, so many opportunities, so many professional opportunities, why Virta? What are the things that got you excited about us, and our mission, and what we are up to?

Siobhan Nolan Mangini

Yeah, well, I mean one thing, Sami, is what you just said. So the mission I think is incredibly important. So what Virta is about and its goal of reversing Type 2 diabetes in over 100 million people. Diabetes is I think one of the most endemic conditions and I would say diseases that are facing us as the society right now.

So one in four healthcare dollars goes to diabetes and I am very compelled by the solution that Virta brings. I say on top of that, it's all about people. And so I loved getting to know you better, Sami. I loved getting to know the team. And so I think those two things really added up for me of I think you're tackling a problem that's incredibly important to society, and you've got a great team, and a great mission.

Sami Inkinen

Well, thank you very much for that. So speaking of operating experience, and also scaling, and sort of living up to that bold mission of helping millions of people reverse their type 2 diabetes, that's a big job for us, and for me, and our team to scale. Any sort of public advice that you'd like to share in scaling a technology company that also has a human sort of heavy operational component? Any advice you would have to share with me and our team?

Siobhan Nolan Mangini

Yeah, it's a great question. Operational excellence never stops. And actually I think some of the most exciting and fun moments are where Virta is today, where there is a great product, and it is about scaling to millions and millions of people. I think one of the key things is actually it's a growth mindset and continually improving.

I say this all the time, you are what you measure, so making sure that you've got the right metrics in place, that you've got a team with that growth mindset that's thinking about how can we use new tools, new solutions, new processes to improve? And then actually having that mission underline it where the more you improve, the more people get access to Virta is really important.

Sami Inkinen

We are excited to have you help us in this task of scaling and succeeding in our mission. So maybe then switching gears a little bit, talking about the broader healthcare ecosystem, and obviously it's more than $4 trillion of annual spending in the US, so there's a lot of things happening in healthcare.

So sort of twofold question, what are the other exciting things you see—either companies or otherwise—happening in US healthcare? Then also, given the scale and size and lot of incumbents and startups, how do companies stand out? How can companies like Virta stand out in this giant market that has a lot of companies and interests? This is sort of a twofold question. What's exciting and then how do companies and exciting companies stand out?

Siobhan Nolan Mangini

Yeah, I think in terms of the first thing, what's exciting that's happening right now, and I think it's an incredibly exciting moment in healthcare. I would actually say for me it's artificial intelligence/machine learning right now in healthcare, I think is going to be transformational. I think there's applications for sure with Virta, and I can see you nodding. And I think within artificial intelligence, you're seeing the impact just begin.

On one side, on the scientific side, there's huge leaps forward that's happening in predicting protein structures that's like many, many millions of times where we were even a couple years ago. And then you're seeing more recent activity with Microsoft, and Nuance, and GPT-4 where they're automating voice-to-text workflows for physicians. So it's like I think all across healthcare, those are just really tangible examples, but I think we're at the very, very beginning of seeing how this can be used.

And maybe that leads to the second thing in terms of how do you stand out, I think it's actually delivering the holy grail of improved quality care, and outcomes, and reducing costs. And I think that's something for Virta that I really loved talking with you about, Sami, in terms of you actually had the actuarial data to show that that's happening with Virta. And I think that's ultimately what we're all trying to do.

You mentioned this, this huge industry, so many dollars, so much wasted dollars, and what will I think separate companies is when you can really deliver quality care for reduced costs and improved outcomes ultimately. And having that substance, I think we were coming out of a period that was really noisy and sometimes folks couldn't discern the signal from noise. And now I think the companies that have true underlying data to support their products are going to be the ones who stand out.

Sami Inkinen

I'm glad you mentioned the AI there, and maybe there's a topic for another conversation for us to talk about what we've actually done practically with the sort of large language models and GPT-3, 4, and we'll see GPT-5 when it eventually comes out how it can actually be applied to care delivery. But we'll leave that for another conversation.

But speaking of dollars and economic savings, obviously there's been a pretty substantial change in the markets. Everybody knows interest rates are up, valuation multiples are down, generally speaking, and sort of focus on the cash efficiency, profitability is everywhere, not just in healthcare. How do you see those kinds of market, public market, private market conditions affect companies, companies like Virta, and then also larger scale companies? What's your take on that in the healthcare context?

Siobhan Nolan Mangini

Yeah, as I was just sharing, I think we are coming out of a period where the fundamentals weren't necessarily in place. And so I used the word signal to noise, but there was just a lot of excitement, which was great, coming through the pandemic, but not necessarily based off of, "Okay, what's a real, valuable solution to society and really fixing some of these serious problems in healthcare that exist."

And so I agree with what you just said. It's going to be a focus on profitability, and margins, and cash flow. Some of these are really business modeling, unit economics. What can feel boring, but actually real because back to scaling to have an at scale business if that works, then that everything else can follow.

And so I do think that we're going to be in a period for a while that focuses more on, okay, get your unit economics, the value proposition to the patient, it really nailed down and then scale from there. And I think that will end up separating a lot of companies, and I think we'll probably see a lot of consolidation as well as a result of that.

Sami Inkinen

Yeah, I internally sort of keep repeating that. It's actually not new. This is just back to basics.

Siobhan Nolan Mangini

Yes, exactly.

Sami Inkinen

We all have to balance our checkbooks at home. We can't burn and spend more than comes in, and it's no different in business. And maybe for the last 5, 6, 7 years, there was a time when people thought it's fundamentally different, but it's the basics. You can't burn, spend more than comes in, and it's a good time to build a good business I would say.

Siobhan Nolan Mangini

I agree. Yeah, and I agree with you, too, that we've been in a kind of unrealistic situation of free money and now it's like, "Okay, build a good business," and I think you'll differentiate yourself tremendously.

Sami Inkinen

Well, let's just finish off with a couple of personal questions. You already mentioned why you came to healthcare, but even on a deeper level, what motivates you professionally on a day-to-day basis? What is it that kind of gets you up and excited for your own professional work?

Siobhan Nolan Mangini

So I would say mission and impact, and the word I use a lot of times is impact is really, really important to me. So knowing that there will be societal impact and potentially if things work well at a profound scale is part of what motivates me every day. It's why I was excited about Virta, it's how I've chosen my career path many times, is based off of this idea of societal impact.

And, I would say team. So I love working with great, talented, passionate, mission-driven people. And so getting to work with a great team is absolutely what motivates me every day.

Sami Inkinen

Well, I would 100% agree on a personal front it's the same thing for me, mission. And obviously at Virta it's reverse Type 2 diabetes in 100 million people. And then the second part is the people we get to do this important work with. And yeah, thank you so much for joining this little conversation. But more importantly, we're excited to have you as part of our board of directors, and part of this important mission, so thank you so much.

Siobhan Nolan Mangini

Yeah, thanks for having me. And it's great to be here, and I'm so excited to be on the journey with you.

Sami Inkinen

Thank you.