Three engagements. Different in scale, sector, and stakeholder dynamics. The same depth of work.
ATLANTA-BASED HEALTHCARE SAAS · INC. 5000 · ACQUIRED BY RELATIENT AUGUST 2021
Radix Health (now Relatient)
The challenge
A founder-CEO operating in an increasingly crowded healthcare SaaS space — navigating a critical transition with customer priorities pulling in opposite directions. Large hospital systems demanding one direction in engineering and product, long-standing private practice clients demanding another. A leadership team attempting to deliver both, with engineering and product near burnout. No shared way to decide which clients to pursue or where to focus limited engineering and product capacity.
Our approach
Two annual planning retreats over 24 months — under 10 days of David's time across both. Before each retreat, individual conversations with every leader and key board members.
November 2019 retreat aligned a 10-person team — founder-CEO, COO, CTO, VP Sales & Marketing, leads from client operations and product, and two board members. Worked through interpersonal dynamics and communication patterns across the leadership team. Every leader who entered that retreat continued through the next year.
Resolved the central strategic question — which customer segment to prioritize against limited engineering capacity — and produced the first defined strategy and priorities the team had agreed on together: BHAG, decision rights, customer segmentation framework, and the integrated annual targets.
November 2020, the second retreat brought 14 people into the room at a pivotal inflection — the leadership team had restructured to accelerate growth and position the company for the opportunities ahead. A Chief Product Officer, Chief Growth Officer, and VP of Product had been added at the senior level, and five director-level leaders — across client success, engineering, and business development — were brought into strategic planning at this level for the first time. The retreat locked core values, set targets, and established ownership across the expanded team.
"I've done a bunch of these over the years, dozens, and this is the best one I've ever done."
— Jim Denny, Board Member, Radix Health
NORTH CAROLINA · MEDICAID IMPLEMENTER · $150M ORGANIZATION
Community Care of North Carolina
The challenge
North Carolina's designated Medicare and Medicaid implementer — a federally funded network serving more than 1.6 million Medicaid beneficiaries through proven population health capability. When ACA implementation produced multibillion-dollar structural losses across Fortune 10 and Fortune 50 commercial payers, those payers came looking for the capability CCNC had built. The question was whether and how to serve them.
Our approach
Engaged the CFO and CEO to lead the strategic process, alongside a former direct report to the COOs at both payers — bringing inside knowledge of what those organizations actually needed. Drove alignment across two boards comprising health system leaders, state-level providers, and former payer executives. Addressed each board member's concerns with rationale and analysis. Resolved active internal resistance from senior leadership with direct CEO relationships by engaging the substance of the concerns, not the personalities behind them.
Both boards approved a five-year strategy, an operational transformation plan with multiple workstreams, and a goal to save the state $1B+ while measurably improving healthcare outcomes. Established a transformation PMO with DACI structure and onboarded three senior leaders from outside the organization to lead execution. For four months David held interim operational leadership of the function — with no predecessor in the role and the incoming COO present part-time — and built the execution infrastructure that the COO inherited and used to begin implementation.
TERWILLIGER CENTER FOR INNOVATION IN SHELTER · GLOBAL INNOVATION HUB · $1.7B ORGANIZATION
Habitat for Humanity International
The challenge
Established as the keynote initiative within Ron Terwilliger's $100M commitment to Habitat for Humanity — the largest individual gift in Habitat's history. MicroBuild — the Center's $100M+ capitalized housing microfinance fund — had proven the market systems model, with impact beginning to eclipse the legacy parent organization's direct delivery. The question was what's next. Dozens of competing program focus areas had surfaced from four stakeholder groups: the Center's advisory board, an outside market research firm, the Center's leadership team, and HFHI's executive team. Each had standing to influence the outcome. The mandate was to land on the right three to five focus areas the entire organization could commit to.
Our approach
Led a year-long strategic prioritization where the stakes were significant and the alignment was complex. $30M had been committed and another $30M contingent on the strategic decisions that would shape the next chapter.
Drove the process across the Center's senior leadership, HFHI's executive team, and an advisory board comprising HFHI's major donors and Marja Hoek-Smit (Wharton), the world's leading academic authority on global housing finance.
Reconciled an external market landscape assessment against the internal read on what each stakeholder group was carrying. Landed the three to five program focus areas the Center would pursue and that the entire organization could commit to. The board approved a multi-year strategy the organization owned and implemented.
Designed the organizational structure to execute — focus, expertise, and service area replacing regional leadership. The Center grew from under 40 to over 75 staff. The contingent funding was unlocked over the next year. 3 additional engagements followed over 4 years for key partnership decisions and inflection points in the strategy's execution.