CTO interview: Neetu Rajpal, building a resilient tech stack for Oscar Health
In this edition, I’m speaking with Neetu Rajpal, CTO of Oscar Health, a tech minded Health Insurance company changing the way people engage with their insurance companies. In her role Neetu makes sure Oscar Health moves forward in their innovative native-cloud approach to selling insurance. In the interview she discusses her formative experience at Microsoft, and her prior position as CTO at Conductor, while illuminating the challenges facing tech companies in the healthcare industry from tech integration to attracting talented programmers.
I see you’ve spent more than 18 years at Microsoft. How did that prepare you for what you’re doing today, leading the technology at Oscar Health?
Microsoft was a really great experience. I didn’t realize at the time, but it felt like I was getting a postgrad education on how to build software. I spent a lot of time, on many different teams throught out my time at Microsfoft. I worked on everything from very low level platform software like XML and .Net to very large enterprise solutions like Exchange server and Office 365. My drive to move teams and keep learning was always rooted in curiosity and seeking new challenges. I switched teams every few years and ended up working on tech that was almost always bleeding edge. I would also find myself being the youngest and the one who knew the least when I got to a new team so I learned a lot. I began to understand how to build good software, to define good software, and realize software’s impact on the value of a business. I feel very grounded in this experience at Microsoft and I will always be thankful to my colleagues and mentors there.
It was extremely helpful to build a concrete picture of what “good” looked like in my head, and this has guided my career. Microsoft is a very large company, Oscar is much smaller, so the context is obviously different. But I remember things that I can still implement, my time at Microsoft gave me the internal compass that guides me today.
You were VP of Engineering. How do you compare the responsibilities of that role with the one of CTO?
The CTO position at Oscar is not the first time I am in this position. Prior to Oscar, I led the Product, Engineering, Infrastructure and IT teams as the CTO and CPO for Conductor. When I came to Oscar, the big change, the most important thing, was working in healthcare. Healthcare in the US has a lot of room for improvement, and tech integration is definitely one of them. I wanted to spend my time and energy fixing things, so for me I didn’t care so much about the position as long as my work was having an impact.
Progression to a CTO position was just natural. One big difference, in general, between VP and CTO is how you think about your tech stack and how much your position requires you to interacts with the rest of the company. Another is how much time you spend managing your team versus how much time you spend doing everything else. VPs end up spending a lot of time making sure the team is set up correctly, establishing processes and putting tools in place regarding reviews and tech deliverable.
CTOs spend a lot of time figuring out how the whole tech stack supports forward movement for the company. In particular at Oscar, it’s my job to look at the tech stack and evaluate how we can impact the rest of the industry and then create a competitive advantage. A CTO’s role fluctuates across the board, depending on the configuration of the business, team or industry you’re in. In smaller companies, a CTO role may actually be a more akin to a chief architect, in other places, it can be more managerial, I think the sweet spot is figuring out how to use tech to build a competitive advantage for the company and this normally stretches to being the technical strategist, the translator of tech speak to the business speak and vice-versa.
Can you tell me more about Oscar Health’s mission?
Oscar started about 10 years ago with the idea to make health insurance more accessible and easier to navigate. When the ACA was signed into law by the Obama administration it created a market for insurance companies to sell insurance directly to individuals who were not receiving it from their employers. Uninsured individuals used to make up a significant population in the US. The UK has the National Health Service, but we don’t have that in the US. Here, depending on your socio-economic status, the government helps you with subsidies.
Oscar built a tech stack that is used to provide health insurance and our membership is now short of a million. Most novel thing about Oscar is that we reimagined how to bring this to market, we did this by building our own cloud native tech using everything we know about building modern software. Everything from members acquisition, experience, billing management, to supporting brokers, back end claims processing is done on tech built by us.
We sell health insurance directly to people on the ACA market places, and are looking to help others utilize our tech stack in their own health plans.
What is the biggest technological challenge you’re encountering, and how do you solve it?
Health insurance tech is very fragmented. Moving information from one place to another is a challenge. There’s a lack of standards, and unique boutique contracts from parties we don’t control. Building a tech stack for things we have very little control over requires a lot of work and resilience. The key is the ability to react rapidly and effectively to whatever’s not working. This is one of the biggest challenges. When a problem is well defined it’s easier to solve, but in this industry you can’t just move fast or you’ll break things and you can’t always afford to break things when it comes to people’s health. You have to be fast and effective because we’re dealing with things we can’t break.
There’s a lot of workforce competition today, programmers are in high demand, but low supply. How can tech companies attract tech talent?
This is the story of our time, I’m not really sure there is an easy answer. The global competition for tech talent inflates compensation, it’s a pretty simple supply-demand curve. We have to accept we live in a world where talent is super expensive, so you need to be precise about the talent you’re hiring, where you’ll apply the talent and where to leave things alone.
It helps to talk to the talent in unusual places, people grow into their positions they don’t necessarily have to be from an Ivy League school. Be honest with people, be transparent, pay fairly, and be precise about how their capacity will be used. Though a mission driven approach to a position always help, it is not a requirement. Most software professionals want to solve problems, tell them about the problems you want to solve and how they’ll add value to the team, then give them the agency to make their decision.
If you want to connect with Neetu, click here.
To learn more about Oscar Health, visit their website: hioscar.com
If you’re a techie working on something exciting or you simply want to have a chat, get in touch with me. I’m currently CTO at Kolleno.com
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