Nearly 90% of Americans suffer from metabolic disease, Manu Diwakar tells us, citing a recent McKinsey & Company study. For Diwakar, CFO of Virta Health, that statistic defines both the scale of the challenge and the clarity of the mission.

Metabolic disease, he explains, includes type 2 diabetes, obesity, liver disease, kidney disease, heart disease, and high blood pressure—“branches of a tree,” he tells us, all sharing the same root cause: poor nutrition. Virta’s model blends medical professionals and technology to reverse those conditions, partnering with insurers, employers, and government entities in a B2B2C framework.

From a finance perspective, the impact is measurable. Diwakar tells us Virta uses pharmacy and medical claims data to compare enrolled members with non-enrolled employees who share the same conditions—creating what he describes as a “really clean A/B test.” For type 2 diabetes, the company delivers a “two-to-one ROI,” he tells us, making the value proposition tangible.

In a market captivated by GLP-1 drugs, the numbers sharpen further. Virta charges about $150 per month, Diwakar tells us, compared with roughly $1,000 per month list price for GLP-1s—about $500 after rebates. More important, he notes that when patients stop GLP-1s, weight often returns. By targeting the root cause—nutrition habits—Virta aims to make results sustainable and long-lasting, he tells us.

For Diwakar, disciplined measurement and root-cause thinking align strategy with impact—improving health while lowering cost.

Before his first cup of coffee, Alex Melamud opens Slack—not to scan revenue charts first, but to read customer feedback. “The first one that may surprise you as a CFO that I look at is actually NPS,” he tells us. At Engine, every survey drops into a shared channel so “every executive can see” what customers said, he tells us.

That habit fits a finance leader who didn’t grow up in the CFO seat. Melamud started in investment banking and then spent 16 years in private equity, learning to build theses, chase signal, and “sell… the product of private equity,” he tells us. Sitting on boards, he watched the CFO role evolve from “corporate governance accounting” into “executive first and maybe CFO second,” he tells us—someone who can talk like product, sales, or operations and earn board trust.

Engine became the moment he stepped inside. After leading the company’s round “18 months ago,” joining the board, and helping with a CFO search, he looked at founder “Eli” and asked, “what if I joined you as CFO?” he tells us. The draw was a focused mission: serving SMB travel, where customers book “like a consumer” and lose corporate rates and visibility, he tells us.

Now his investor lens shows up in the unglamorous work. During annual planning, he dug into the “top 50 costs” outside headcount and pushed leaders to treat each contract “as a brand new relationship,” he tells us—an inspection that produced “10, 15%” savings and “tens of millions of dollars,” he tells us.

On her first day as CFO at Greenphire, Sue Vestri sat in a conference room “learning all of the acronyms” of the clinical trial industry, she tells us. There were “many, many, many,” she recalls, and she listened to the sales team outside her door to understand how the product was positioned and why it mattered.

That willingness to learn from the ground up defines her career. Earlier, a mentor warned her she would stagnate if she stayed in the safety of a large company. “You’ve got to go to grow,” he told her. She left for a 100-employee cloud software firm, a decision that launched a string of growth-company chapters, transactions, and ultimately multiple CFO seats.

At Greenphire, she joined when the company had roughly 72 employees and “very low double digit revenue,” she tells us. Under private equity ownership, it expanded globally, shifted from clinical sites to big pharma customers, and supported the Pfizer clinical trial during COVID. Sue and her CEO conducted “20 or 30 presentations” during a remote exit process, she tells us.

Today, as CFO of CRIO, she describes finance as embedded in the business—not “sitting behind a desk… producing financial statements.” Her filter for AI is deliberate: avoid the “shiny object” and invest in what is “truly transformational,” she explains. Whether evaluating predictive revenue indicators or AI tools, Sue’s throughline remains the same—grow, but with discipline.