From Startup Founder to Healthcare AI Engineer: My Journey

Eighteen months ago, I was the Founder and CTO of ReachGig, building a freelancing platform from scratch. Today, I'm a Founding Engineer at Mantys Healthcare AI, a Y Combinator company developing AI systems that serve 10+ hospitals. This transition taught me invaluable lessons about pivoting careers, choosing opportunities, and applying technical skills in entirely new domains.

The ReachGig Chapter: Building from Zero to Market

ReachGig was my first real experience building a company from concept to market. As Founder and CTO, I wore multiple hats:

Technical Leadership

Built the complete platform using Next.js 14, Node.js, and AWS serverless architecture
Designed scalable infrastructure achieving 99.8% uptime
Developed cross-platform React Native applications
Implemented CI/CD pipelines reducing deployment time by 70%

Business Operations

Led product strategy and user acquisition
Managed cross-functional teams across engineering, marketing, and operations
Navigated the challenges of building in the competitive freelancing space

Key Achievements

Reduced infrastructure costs by 40% through optimized serverless architecture
Built notification systems with 99.5% delivery rate
Successfully launched and gained initial market traction

The Pivot Decision: Why I Left My Own Company

Leaving a company you've built from scratch is never easy. The decision came down to several factors:

Market Realization

The freelancing platform space, while large, was becoming increasingly saturated. Giants like Upwork and Fiverr dominated, and newer entrants needed massive capital to compete effectively.

Personal Growth

After two years as a founder, I was hungry for new technical challenges. I wanted to work on problems that were:

Technically complex: Healthcare AI presented fascinating engineering challenges
Socially impactful: Directly improving patient care and healthcare efficiency
Cutting-edge: Working with the latest AI/ML technologies in production

Team Dynamics

Y Combinator's network and the quality of the Mantys team were compelling. Working alongside other exceptional engineers in a fast-moving environment was exactly what I needed for my next growth phase.

Transitioning to Healthcare AI: New Domain, New Challenges

Moving from freelancing platforms to healthcare AI meant learning an entirely new domain while applying my existing technical skills.

Domain Knowledge Acquisition

Healthcare has unique complexities:

Regulatory requirements: HIPAA compliance, FDA regulations
Data sensitivity: Patient information requires exceptional security
Industry knowledge: Understanding medical coding, insurance systems, prior authorization workflows

Technical Skill Evolution

While my core engineering skills transferred, I needed to develop expertise in:

AI/ML systems: LLM integration, evaluation frameworks
Healthcare data processing: Medical record parsing, claims processing
Compliance engineering: Building systems that meet healthcare standards

The Learning Curve

The first three months were intense. I spent countless hours:

Reading healthcare regulations and industry standards
Understanding medical coding systems (ICD, CPT)
Learning about insurance provider workflows
Studying state-of-the-art AI/ML techniques for healthcare

Applying Startup Skills in a New Context

My experience building ReachGig provided unexpected advantages in the healthcare AI space:

Systems Thinking

Building a platform from scratch taught me to think holistically about:

Scalability: Healthcare systems need to handle massive data volumes
Reliability: Downtime in healthcare has serious consequences
User experience: Complex healthcare workflows need intuitive interfaces

Full-Stack Perspective

Having built everything from frontend interfaces to backend infrastructure helped me understand:

How AI models integrate with existing healthcare systems
The importance of API design for healthcare interoperability
Performance optimization for large-scale data processing

Business Acumen

Startup experience provided crucial business understanding:

Customer needs: Healthcare providers have specific, complex requirements
Market dynamics: Understanding how healthcare technology decisions are made
Value proposition: Quantifying impact in terms of cost savings and improved outcomes

Current Work: Building Production Healthcare AI

At Mantys, I'm working on systems that directly impact patient care:

LLM Evaluation Framework

Built comprehensive evaluation systems using Cove and Gevals, achieving 98% accuracy in medical data extraction while reducing manual verification by 80%.

Prior Authorization Automation

Developed PA decision-making systems that automate 120k+ medical procedures, replacing teams of 8-10 specialists with 2-3 staff members.

Claims Recovery System

Architected financial reconciliation systems that recovered $2.3M in pending claims, reducing reconciliation errors by 90%.

Lessons for Career Transitions

This transition taught me several key lessons about changing career paths:

1. Core Skills are Transferable

Strong engineering fundamentals apply across domains:

System design principles
Performance optimization
Code quality and testing
Team collaboration

2. Domain Knowledge is Learnable

While healthcare seemed intimidating initially, focused learning made it accessible:

Read industry publications and research papers
Connect with domain experts
Start with small projects to build understanding
Don't be afraid to ask questions

3. Timing Matters

The intersection of AI advancement and healthcare needs created perfect timing:

LLM capabilities reached healthcare-applicable levels
Healthcare providers were ready for AI adoption
Regulatory environment was becoming more AI-friendly

4. Network Effects are Powerful

Y Combinator's network and the quality of opportunities it provided were game-changing:

Access to exceptional co-founders and team members
Connection to investors and advisors
Exposure to cutting-edge problems and solutions

Advice for Other Founders Considering Transitions

If you're a founder considering a similar transition:

Evaluate Your Motivations

Are you running from problems or toward opportunities?
Do you want new technical challenges or just a break from founder stress?
Are you passionate about the new domain?

Leverage Your Experience

Highlight your systems thinking and business acumen
Emphasize your ability to build products from scratch
Showcase your experience with rapid iteration and customer feedback

Choose Wisely

Look for teams and problems that excite you
Consider growth opportunities and learning potential
Evaluate the long-term trajectory of the industry

Looking Forward

The transition from startup founder to healthcare AI engineer has been one of the best decisions of my career. I'm working on technically challenging problems with direct social impact, alongside exceptional teammates, in one of the most important industries of our time.

Healthcare AI is still in its early stages, and the opportunity to shape how technology transforms patient care is both exciting and humbling. Every system we build has the potential to improve outcomes for thousands of patients.

For other founders considering similar transitions: the skills you've built starting companies are incredibly valuable. Don't underestimate how much your startup experience has prepared you for complex, fast-moving environments in any industry.

Harshavardhan is a Founding Engineer at Mantys Healthcare AI (YC W23). Previously, he was Founder and CTO of ReachGig. Connect with him on LinkedIn to discuss career transitions, healthcare AI, or startup experiences.