First Builders

How do you build a billion-dollar company when you’re not in Silicon Valley?On this episode of First Builders, hosts Amber Illig and Rachel Tsui sit down with Jack Greco co-founder, COO & CFO of ACV Auctions, which went public at a $3.85 billion valuation, to explore what it means to build and scale from the ground up in Buffalo, New York.Jack shares what it took to transform a scrappy regional idea into a national marketplace for auto dealers—and the lessons learned from leading teams through hypergrowth, crisis, and IPO.In this episode, Jack reveals:– How ACV went from a Buffalo startup to a $3.85 B public company– Why culture, character, and cash flow matter more than hype– What “first builders” get right before product–market fit– The reality of building outside traditional tech hubs– How he now backs early operators through The Council and the Buffalo ecosystemIt’s a raw and real conversation about founding with grit, building without blueprints, and creating companies that last.FOLLOW JACK GRECOLinkedIn: https://www.linkedin.com/in/jackgrecoTwitter/X: @jackgreco716The Council Capital: https://thecouncil.coFOLLOW THE COUNCIL & FIRST BUILDERSYouTube: https://www.youtube.com/@firstbuilderspod⁠Newsletter: ⁠https://thecouncil.beehiiv.com/subscribeInstagram: @thecouncilcapitalTwitter/X: @first_builders_LinkedIn: The CouncilTikTok: @firstbuilderspod

What if healthcare started at home?In this episode of First Builders, hosts Amber Illig and Rachel Tsui sit down with Cameron Carter, Founder and CEO of Rosarium Health, a company helping older adults and people with disabilities age safely in place through smart home modifications.A seasoned healthcare operator turned founder, Cameron previously held leadership roles at Truven (acquired by IBM Watson), Evolent Health (IPO), Bright Health (IPO; later acquired by Cigna), and DaVita before taking a personal mission and turning it into a company.In this episode, Cameron shares:– How building a ramp for his aunt on Medicaid sparked the idea for Rosarium Health– The scale of the “silver tsunami” and why aging in place is a necessity, not a luxury– What the new “Big Beautiful Bill” means for Medicaid, providers, and founders building in regulated markets– Why policy knowledge is a strategic advantage for healthcare startups– And why “move fast and break things” doesn’t work when lives are on the lineIt’s a deep-dive into mission-driven healthcare innovation — and a masterclass on how to turn policy into opportunity.FOLLOW CAMERON CARTERLinkedIn: https://www.linkedin.com/in/cameron-carterRosarium Health: https://rosariumhealth.comRosarium Careers: https://rosariumhealth.com/careersFOLLOW THE COUNCIL & FIRST BUILDERSFollow The Council & First BuildersYouTube: https://www.youtube.com/@firstbuilderspod⁠Newsletter: ⁠https://thecouncil.beehiiv.com/subscribeInstagram: @thecouncilcapitalTwitter/X: @first_builders_LinkedIn: The CouncilTikTok: @firstbuilderspod

What if freezing your eggs could also help another family grow theirs?In this episode of First Builders, hosts Amber Illig and Rachel Tsui sit down with Lauren Makler, Co-founder and CEO of Cofertility—a groundbreaking fertility company where women can freeze and store their eggs for free if they donate half to a family in need.Lauren spent nearly nine years at Uber, scaling from marketing to leading strategy at Uber Health before turning her attention to one of the most personal and impactful challenges: fertility. With Cofertility, she’s building a model grounded in empathy, transparency, and community.In this episode, Lauren shares:– How her personal journey shaped the vision for Cofertility– Why empathy is a founder’s superpower in healthcare and family-building– Lessons from nearly a decade at Uber, from hypergrowth to healthcare strategy– The power of building mission-driven teams tackling sensitive problems– How Cofertility is changing the economics and access of fertility careIt’s a story of scaling with purpose, centering humanity in healthcare innovation, and building a company designed to last.Follow Lauren MaklerLinkedIn: https://www.linkedin.com/in/laurenmakler/Cofertility: https://www.cofertility.com/Cofertility Careers: https://www.cofertility.com/careersFollow The Council & First BuildersYouTube: https://www.youtube.com/@firstbuilderspod⁠Newsletter: ⁠https://thecouncil.beehiiv.com/subscribeInstagram: @thecouncilcapitalTwitter/X: @first_builders_LinkedIn: The CouncilTikTok: @firstbuilderspod

What does it really take to build in healthcare from the ground up? In this episode of First Builders, Amber Illig and Rachel Tsui sit down with Eliana Berger, co-founder and CEO of Joyful Health—a financial operating system for independent healthcare providers. Eliana has been a “first” more than most: first PM on Attentitve’s conversational messaging team, first PM at Charlie Health, founding PM at Moonbeam, and co-founder of Envision Accelerator, the first equity free accelerator for underrepresented founders. In this episode, Eliana shares more about: – Embedding herself inside practices as a fractional CFO– Become biller-certified to understand the messy realities of revenue cycle management (RCM) – How to build trust with clinicians in the era of AI skepticism – How community building, workshops, and radical transparency became Joyful Health’s GTM edge– Why going slow to go fast has been her core principle as a founderIt’s a conversation about tackling the messy problems in healthcare, diving in deep to understand the root problems, and creating a company that lasts. Follow Eliana BergerLinkedIn: https://www.linkedin.com/in/elianaberger/ Joyful Health: https://www.joyfulhealth.io/ Careers at Joyful Health: https://www.joyfulhealth.io/careers#section-careers Make sure you follow us on all our social channels below and watch full episodes on YouTube! Subscribe to our newsletter to get new episode drops in your inbox.Your HostsAmber & RachelInstagram: @thecouncilcapitalTwitter/X: @first_builders_LinkedIn: The CouncilTikTok: @firstbuilderspod

What does it take to scale a healthcare data company over a decade—while bridging silos across an entire industry?Web Sun, Co-Founder and President of Komodo Health, joins First Builders to share the company’s journey from an early idea with bold ambition to a global leader in healthcare insights. Over ten years, Komodo has grown into a category-defining platform that powers better outcomes by aligning payers, providers, and pharma through data.In this episode, Web opens up about:– The early insight that sparked Komodo and how he met his co-founder, Arif Nathoo– Scaling a company across two coasts and two talent pools—even before remote was the norm– The hardest leadership decisions that come with growing from 20 people to 200+– What it means to reframe leadership every year in hypergrowth– How to build trust in a system where collaboration doesn’t come naturallyIt’s a conversation about playing the long game, scaling with intention, and shaping healthcare for the better.Follow Web SunLinkedIn: https://www.linkedin.com/in/websunKomodo Health: https://www.komodohealth.comMake sure you follow us on all our social channels below and watch full episodes on YouTube!Subscribe to our newsletter to get new episode drops in your inbox. Your HostsAmber & RachelInstagram: @thecouncilcapitalTwitter/X: @first_builders_LinkedIn: The CouncilTikTok: @firstbuilderspod

What happens when a frustrated operator decides to solve her own problem—and ends up building one of the most empathetic AI companies in the market?Lisa Popovici, Co-founder of Siena AI, joins First Builders to share how running multiple e-commerce brands led her to create a conversational AI platform that actually understands customer sentiment, not just scripted keywords.Before launching Siena, Lisa felt firsthand the pain of delivering great customer experience while protecting margins and sanity. Today, Siena has raised $10M+ from investors including Sierra Ventures, Partech, Aglaé Ventures (LVMH), and The Council Capital. Their AI agents handle high-emotion customer conversations—at scale—without losing the human touch.In this episode, Lisa shares:– How she went from DTC founder to AI entrepreneur before the 2023 AI boom– The hardest pitch she ever made—and the moment she knew she had to build Siena– Why “empathy at scale” isn’t a buzzword but a moat– Lessons on co-founder dynamics, hiring for early teams, and standing out in a competitive AI market– Why traditional customer support isn’t dead—but is being radically redefinedIt’s a masterclass in turning pain into product and building tech with a soul.Follow Lisa PopoviciLinkedIn: ⁠https://www.linkedin.com/in/lisapopovici⁠Twitter/X: ⁠https://twitter.com/lisapopovici⁠Company: https://www.siena.cxMake sure you follow us on all our social channels below and watch full episodes on ⁠YouTube⁠.Subscribe to our ⁠newsletter⁠ to get new episode drops in your inbox.Your Hosts⁠Amber⁠ &⁠Rachel⁠Instagram:⁠@thecouncilcapital⁠Twitter/X:⁠@first_builders_⁠LinkedIn:⁠The Council⁠TikTok:⁠@firstbuilderspod⁠Show NotesLisa’s journey from e-commerce founder to AI entrepreneurBuilding Siena AI before the mainstream AI waveDesigning AI agents that read emotional context, not just textCo-founder dynamics and staying aligned over years of buildingWhy empathy and defensibility are core to CX innovationLessons for founders hiring their first 10 employees

David Hoang, VP of Design at Atlassian and a seasoned design leader with experience at Webflow and Replit, shares insights on building impactful design infrastructures. He discusses the critical timing for hiring a first designer and the importance of authenticity in a founder's voice. David emphasizes how design should drive growth rather than be an afterthought and highlights lessons from his diverse experiences in tech companies. With a focus on user-centered design, he explores the future of design amidst AI advancements and the need for resilience in leadership.

How does a doctor become a startup founder? Danish Nagda, Co-Founder & CEO of Rezilient, joins First Builders to share his journey from the hospital floor to reimagining how care is delivered for high-risk patients.Danish left medicine to co-found Rezilient, a virtual-first care platform connecting patients to their providers in ways traditional systems can’t. He’s also the host of Uncanny Valley, where he explores the real stories of founders and innovators breaking into tech.In this episode, Danish shares:– Why being an outsider in Silicon Valley became his advantage– How adaptability shaped Rezilient’s growth through market shifts– Lessons on founder-led sales and building a personal brand– The co-founder dynamics that keep his company strongIt’s a conversation about identity, conviction, and building boldly—inside and outside of Silicon Valley.Follow Danish NagdaLinkedIn: https://www.linkedin.com/in/danishnagdaCompany: https://www.rezilienthealth.comPodcast: Uncanny ValleyMake sure you follow us on all our social channels below and watch full episodes on YouTube.Subscribe to our newsletter to get new episode drops in your inbox.Your HostsAmber & RachelInstagram: @thecouncilcapitalTwitter/X: @first_builders_LinkedIn: The CouncilTikTok: @firstbuilderspodShow NotesDanish’s path from medicine to co-founding RezilientBreaking into tech as an outsider and building credibilityFounder-led sales and personal branding for early-stage leadersLessons on co-founder alignment, scaling, and team building

Cecilia Ziniti, CEO of GC AI and former General Counsel at multiple high-growth companies, shares her fascinating journey from law to AI leadership. She discusses recognizing the perfect moment for innovation in legaltech and the essential mindset shifts for aspiring startup founders. The importance of team building and risk management in the AI landscape is highlighted, alongside insights on product-market fit within legacy industries. Her unique blend of legal and tech experience proves to be a powerful catalyst for success in this evolving field.

What happens when a high-growth operator turns founder—and builds a company rooted in personal mission? Koby Conrad, solo founder and CEO of Sunflower, joins First Builders to share his journey from Rupa Health’s go-to-market lead to creating a digital recovery platform for the 1.2 billion people affected by addiction.A former zero-to-one standout at Rupa Health, Koby helped scale the company from a $22M valuation to a life-changing acquisition. Now he’s bringing those lessons—and his own seven years of sobriety—into building Sunflower, a mobile-first addiction recovery app grounded in emotional resonance, habit loops, and community design.In this episode, Koby unpacks:– The early signals he trusted to launch Sunflower– What he learned about growth, management, and mindset at Rupa– How he raised capital pre-launch and built in public– Why being a solo, non-technical founder didn’t stop himIt’s a story about identity, scale, sobriety—and how the best builders are the ones who stay close to the problem.Follow Koby ConradLinkedIn: https://www.linkedin.com/in/kobychaseconradTwitter: https://twitter.com/kobychaseCompany: https://www.joinsunflower.comBook: https://channelsofgrowth.comMake sure you follow us on all our social channels below and watch full episodes on YouTube! Subscribe to our newsletter to get new episode drops in your inbox.Your HostsAmber & RachelInstagram: @thecouncilcapitalTwitter/X: @first_builders_LinkedIn: The CouncilTikTok: @firstbuilderspodShow NotesKoby’s path from Rupa Health to solo founder of SunflowerLessons on startup growth, hiring, and building high-slope teamsInside Sunflower: AI-powered habit tracking, CBT prompts, and community-driven recoveryVulnerability and leadership: staying grounded while scalingBook Mentioned: The Mom Test by Rob FitzpatrickKoby’s book: Channels of GrowthVisit: https://www.joinsunflower.com