Come work with me (at Substrate)

We’re looking for people to come build Substrate (www.substrateai.com) with us. We’re a team of ~10, of some of the strongest people I’ve worked with over my career, and over the next year we’ll hire a few more high impact folks to the team. Consider this an invitation to come work with us (or share this with, or nominate someone who should).

I started writing because I ran out of people to talk to about banking (seriously). I’d spent years deep in ledgers, card issuing and reconciliation, and no one I knew wanted to talk about Durbin, tradeoffs between financial reconciliation models, banking partners etc.

Writing has helped me meet people thinking about similar problems, from whom I’ve learned a ton. I’m hopeful it will also help me meet people to work with.

We’ve been building Substrate for almost 2 years. As with many new ideas, there’s a period when you’re walking through the maze, and the way out is not clear. Then there’s a period when you can see all the way through. We’re at a point where I can see several ways through, and we’re now hiring to pick the right one(s) and run at them as fast as we can. Our primary constraint is execution.

What we’re building

We’re attacking a massive problem in an opinionated way:

• We’re helping doctors get fairly compensated for care they’ve delivered.

• I’ve lived what it was like when this doesn’t happen. I’m building Substrate to fix that.

• Healthcare RCM is a massive market. Most players solve problems by throwing bodies at them.

• There are lots of companies you can invest in or join where the model is to either merge with or hire a big outsourced team. Many have raised lots of money, and are growing fast. I applaud them, but that’s not what we’re doing.

• We’re doing the opposite - trying to solve every part of the problem using software & agents. Some examples of what we’re building and the problems they solve:

  • A claim status agent that does the first step of AR Follow Up

  • A policy agent that checks if a payer would consider an encounter medically necessary (before you do a prior auth)

  • Appeals automations that submit medical records requests and attachments to payers

  • Payment reconciliation automations that post exceptions like payer clawbacks, balance patient credits, issue refunds and more

• After all the growth, everyone has to answer the same question: can you actually get software to do these tasks? Can software do these tasks better than humans? We’re answering that question first. We’re front-loading the “eat your vegetables” phase of our development, and we already have material proof that it’s working.

If you’ve ever read my writing and wondered what it would be like to work together, or there’s someone in your world who you think would enjoy it, now’s the chance.

My hiring philosophy

Throughout my career, I’ve leaned hard into hiring mispriced talent, because I’m that. I plan to do that this time too. What do I mean by mispriced? I mean generally that you’re capable of having insane impact, but you’re shaped in a way that employers often don’t know what to do with you. Examples*:

• Unreasonably obsessed: if you enjoy going endlessly down the rabbit hole trying to fix problems once you sink your teeth into them, lets chat.

• Ex founders or founders in transition; you’ve started a company before, and you’re not ready for your next one, but you’re still hunting for a mission. (this also applies if you haven’t started a company before but plan to, or you’re a founding engineer somewhere)

• T-Shaped: broadly strong but unreasonably deep on one dimension (often so deep that you know very few peers with as much applied knowledge as you)

• Career boomerangs: you’ve been out of the workforce for a while, often for personal reasons, and you’re ready to grind, but bigcos will ask you to “explain this gap in your resume” before they politely decline

I deployed this philosophy for over a decade at Carbon and Cash App with spectacular results. In addition to being massively impactful, many alums have gone on to start companies or run teams in their next adventures, going after really big, hairy, ambitious problems. A few examples:

• Alex Cohen, founder/ceo at HelloPatient

• Kalie Dove Maguire, president at Evidently

• Levent Bas, founder/ceo at Altira

• Henrik Berggren, cpo at Mutiny

• Noah Manders, founder at Bsyde

• Maurice Chiang, vp product at Spring Health

There will be more. They could be you.

What I’m looking for

Everyone has buzzwords that they use to describe the people they like to work with. Here are mine.

• Load-bearing: outcomes would be worse if you weren’t present. Fahm spent weeks at Dodger’s stadium mid pandemic, checking in patients in person to ensure a tight feedback loop on the vaccine infrastructure we were building.

• High Urgency: you’re a self kindling fire, and always want everything to go faster

• High Agency: every problem is your problem. Kalie saw patients at Carbon clinics while building the EHR, and built a coding copilot that collapsed both clinical and financial friction.

• Curious: you value understanding over winning arguments, and you’ll get as close to the metal as necessary in service of it. Ashu spent weeks with materials producers to learn how card plastics were mixed and come up with truly unique card combinations.

• Dissenters: it’s your duty to tell me I’m wrong, and call out when things don’t make sense. Henrik called bullshit, in public on terrible product org decisions I’d made, long before I was willing to admit them.

I genuinely believe one of the best ways to get to know someone is to be in the trenches with them and embrace the tension that comes with two disagreements. This will be no different.

What’s in it for you

• We’re no bullshit and low ego, and recruiting primarily in person, in San Francisco. My goal is to build a small, tight knit team that is more than the sum of its parts.

• You’ll go unreasonably deep on systemic, real world problems in healthcare, both at a technical and business level. Everything from reading EDI companion guides, medical necessity policies & healthcare payment regulations to using all that insight in service of processing every single transaction the right way.

• And if we’re successful, doctors get paid fairly!

• Whatever you do after this, I’ll move mountains to help. My knowledge and network are yours.

• The maze metaphor is real: there are several ways through, but the one(s) we pick depends on who is in the room. You’ll influence that.

• (Eventually) swag you’ll love wearing.

Conversely, if you want a clear roadmap or a lot of direction, this isn’t for you. Among other things, we’re hiring for judgement. Even if you don’t fit cleanly into any of these buckets - if you’re in engineering or GTM and interested in healthcare and RCM, please reach out.

We’re hiring for engineering (sample roles here and here) and GTM.

If this is you: email kunle [at] substrate [dot] cc with a couple of bullets on why this is you, and a github/linkedin/resume. Even if you’re not ready for a change today, please reach out. I can be patient.

If you know someone: Send them this post, and why you thought of them.

If there’s someone I should meet: even if they’re not looking, email me their name and why. I’ll reach out thoughtfully.