Scale Like a CEO

How MedTech CEO Justin Ramsaran Scales Teams & Culture | Scale Like a CEO

• Justin Reinert • Season 1 • Episode 57

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What if the skill that built your product is the very thing holding your company back from scaling? We sit down with medtech founder and CEO Justin Ramsaran to unpack the real transition from hands-on builder to culture shaper, and why learning to let go—without losing touch—is the leadership unlock most of us avoid.

Justin traces his path from biomedical engineering and FAA software to global product leadership and founding RGP and Health Mosaic. He shares how he delegated the parts he loved most—product and early sales—by installing clear SOPs, codifying tribal knowledge, and setting rhythms that keep him close to the signal while empowering specialists to execute. We dig into selecting and developing leaders by stress-testing for EQ and resilience: who cools the room when everything is on fire, who manages up when the founder is the spark, and how adversity quotient separates future VPs from strong ICs.

Culture sits at the center. Justin explains how to keep teams flat and fast as headcount grows, using cross-functional squads and decisive ownership to avoid “meeting for a meeting.” When stakes are high, he flies the team together for focused, in-person sprints that compress alignment and decisions into days, not weeks. We also explore decision paralysis with big customers and how perspective shifts—mentors, outside conversations, and even solo sports like tennis—create the mental space to make clean calls. 

Looking ahead, Justin is building an entrepreneurial culture from the inside out: open office hours, hackathon-style experiments, and platforms like an internal podcast to turn curiosity into validated bets. The goal is a learning organization where ideas move quickly from hunch to test to shipment, and where leadership means an open door, clear standards, and real relationships that outlast any single project.

If you’re a founder or operator wrestling with delegation, culture, and speed, this conversation will sharpen your playbook. Listen, subscribe, and leave a review with the one practice you’ll adopt this week—what’s your next step toward a flatter, faster team?

Justin Reinert:

In this episode of Scale Like a CEO, we explore the challenges and strategies of leadership, scaling teams, and building company culture. The conversation features Justin Ramserin, CEO and co-founder of RGP and Health Mosaic, sharing insights from his journey in the medtech space. Thank you for joining me on Scale Like a CEO. It's great to talk to another Justin. So that'll be fun for the transcript, the two Justins. But to get us started, if you wouldn't mind, give us a 90-second intro of you and what you're up to.

Justin Ramsaran:

Yeah, no, absolutely. So my name's Justin Ramsaran. I am the CEO and co-founder of our group and our product health mosaic as well. And in that time period, my background started off as a biomedical engineer post-college, worked for the FAA and developed software for the government for about three years. And I was lucky enough to actually end up in the medtech space, doing development RD, and then moving into more of a global product development role. So managing teams, scaling infrastructures. And then doing that, uh had the ability to spin off and start up my own startup at the same time. Again, kind of collaborating with current customer, current employer, too, which is a very dynamic and unique position, but a lot to learn. I had the ability to learn how to scale, how to grow companies, and then work with these teams as well internationally, not just domestically in the same capacity. I would put that put it in a nutshell for you there.

Justin Reinert:

Nice. Well, you know, you've got your hands at a lot of things. So I have a feeling we'll have a good conversation today. You know, if you think about, you know, as you transition from being a founder of an organization to building teams and merging teams together, what was one of the biggest shifts that you've had to make personally in that kind of shift and growth?

Justin Ramsaran:

It I would call two things out. One, culture, right? Understanding the different dynamics that you're working in, going from what may be a little more legacy, monolithic development, and then having to work with more of an agile, you know, grit startup type of personality. So merging those two together so we can remove silos and move forward has been one piece. But also learning to delegate, doing that in a manner where you're not losing touch to the product or you're not losing touch to what's going on in your industry and field, but also trusting your team. And that comes back to you as the operator, making sure you've got SOPs in place, making sure you're scaling and developing the team the way you want. And then reinforcement on that. So again, kind of those two sides of culture and learning to let go certain parts, but still be involved very heavily.

Justin Reinert:

Learning to let go can be challenging for sure. You know, that the idea of delegation comes up very often in my conversations. And I'm curious, what was one of the hardest things for you to let go as you began delegating?

Justin Ramsaran:

It would have to be the product development side, personally, right? It's you know, you've fostered this, you know, baby essentially, right? You've grown from the ground up, you built it, you're the developer for it. You know, you made the first sales, you knew how to be in front of everybody. And having to let that go to a sales member to take over, you know, teaching that was tough and making sure they understood how to handle a customer, how to be in front of them. I think losing a little bit, if you want to say of that in the weed skills of being the developer like you always need to be. Those are the two tough parts. You know, is definitely being able to let those pieces go, but also know that I still have the skill and capability but have to know where to just kind of step back a touch.

Justin Reinert:

Yeah, when you create something, letting go of that baby and letting other people, you know, do something with it or build on it can be really challenging. You know, as you've grown your teams, how have you gone about identifying and then developing leaders so that you can continue to scale and grow?

Justin Ramsaran:

Yeah, leadership style for me, and then kind of following a servient type of perspective has been important. Giving everybody an opportunity and chance where you see development and growth has been a big thing for transparency. I got the opportunity very young to work with a large Japanese medical device manufacturer, which was Fukuda Denchi, at about 22. And they said, you have a chance, take a shot at it. And that's all I needed was a chance and an opportunity. So again, paying it forward, but also trying to find, you know, the personnel in our team and identifying those skill sets, what can be fostered, because you can build a lot of the technical skills along the way. But I think understanding that EQ and IQ, and then having that adversity quotient as well is super important. And I think seeing the resilience of when they have a problem, how they react, how they manage, and how they build from that have been the ways I've been kind of fostering the growth of the team as well.

Justin Reinert:

Yeah. Those, yeah, the technical skills oftentimes, you know, are are more easily teachable than something like EQ. I'm curious, how have you gone about identifying EQ in folks that you're looking to hire or promote?

Justin Ramsaran:

It's the tough situations, right? When we're in a bind, when, you know, from the startup perspective, it's all on fire, everyone's pointing fingers at each other. Are they adding to the fire or are they finding a way to mediate, kind of delegate the team and bring this all together of instead of the perspective of, okay, well, we have all these issues, we're never going to fix it. It's more of how can we bring this together, though it's a bad time? Can we learn? Can we scale from it? What can we do better? So I think it's in those moments where you can identify the leaders with the EQ piece and how they're managing the rest of their colleagues, even if I'm the one in that moment causing the problem and the fire and being the frustrated one. If they're mediating me, hey, you have a skill of being able to dynamically work with the team.

Justin Reinert:

Yeah, when they're able to yeah, do that kind of managing up and helping, helping to put out the fire sometimes in the senior leaders, that can definitely be a challenge. So another thing that you mentioned, you talked a bit about culture, and I'm curious how what's been the toughest part of maintaining alignment and culture as your organization has grown.

Justin Ramsaran:

It's reducing the barriers of entry and the red tape, right? Again, you start to have people that report to people that report to people, and over that time you start to lose the ability to execute and move quickly as a team. So, from a culture perspective, it's trying to ensure that we kind of keep everything flat as best as we can. And it's a unique approach in that perspective. But I think the best way is to make sure we have a lot of cross-functional team members and the involvement of everybody, being able to foster that, that the voice is being heard. Though again, the ultimate decision does have to be made, leadership and management, things like that. But I think it's vitally important from a culture perspective that we maintain the ability to move agile without having to add a bunch of barriers of entry to deploy a product or a solution. I think we've watched it plenty when we work with our larger customers that they've got to go through about a meeting for a meeting for a meeting. And versus a smaller company, we can make a call and say, I'm gonna push this product, it's gonna do this. Okay. Why not test it and find out? So I think that's one thing we've tried to maintain, but what's also important and hard to resist when you start to delegate as well.

Justin Reinert:

Yeah. Well, and it is as you grow, there those it the communication becomes more challenging to keep everybody on the same page because you've got more people to keep on the same page. And that's oftentimes why we death by meeting, because we need more and more and more people informed. What what are some strategies that you've used to really keep keep the organization flat and keep that agility?

Justin Ramsaran:

It's meeting in instead of a one-on-one meeting, right? And again, group meetings online are tough. It's physically being in person, pulling this all together and having those types of conversations when we need to. And I think that helps a lot because at least in that standpoint, we're able to have the conversation and resolve the issue at the time with the team. So if we try to schedule a QBR or if we're trying to schedule bi-weekly things, I will hop on a flight, bring the team together, and set us all down in a room to get it done. And again, it's a little tasking, but I think at the same time it does help create a resolution and kind of shows the commitment to your team that you're willing to put yourself out there in order to manage when we have a real problem, you know, when there is a discrepancy, when the culture may be shaken a little bit by trying to re-bring it back and unify it at the same time.

Justin Reinert:

Can you think about a time when you were maybe overwhelmed by decision-making? And what helped you to break through in plenty of times, right, to be honest.

Justin Ramsaran:

But the biggest thing, I think we had to make a call with a vendor that we wanted to work with. It was tough because it was a big customer. We didn't know if we want to let them off because of the headache they were bringing, and we were at a disposition because it was our largest customer at the time, and we were also at the crossroads of possibly losing them because of some of our own internal issues. It's really just we weren't able to develop quick enough. The biggest way I think I was able to break through was stepping back, right? I think hitting your head against the wall sometimes and trying to drive at a problem, it does get you there sometimes. But if you're able to step back and I think get visibility from a different angle, a mentor, or just clogging out and genuinely just giving yourself a different point of view perspective, talking to somebody else in a different industry, that's helped. For instance, I think I picked up a couple new hobbies in the last year. I'm a soccer player by trade for years on end, and I picked up tennis, and that helped. That was one of those things. It was a one-on-one sport. So it's just me versus myself, right on the court playing. And I think small things like that added to my routine or just added to when I had these issues, actually helped me realize in a more clear capacity what the issue was and how I was able to make a more clear, concise decision when I had that decision paralysis type of moment going on.

Justin Reinert:

It's so helpful to have those kind of hobbies, things that are outside of work, because I think oftentimes founders, CEOs get so bogged down with the work. And because there it's there's a you know, never-ending source of work when you're growing a company. And so you think that you can't spend time doing other things because it's not the work, it's not growing the business, but we just burn ourselves out that way. And so having those ways to help us shift our mind to other things actually creates a lot of enlightenment that we can then bring back to the day job and help us to see things differently. So I love that you have found that to be a practice that's helpful. Yeah, no, for sure. I'm I'm curious. So as you as you start to kind of turn your eyes to the future, how do you define the leadership culture that you want to build?

Justin Ramsaran:

Good question. I think the culture that I'd like to continue to foster is truly one that allows for the team itself to work not just cross-functionally and dynamically, right? Again, kind of the buzzwords that we I think we all say in the industry, but I think allowing for investment back into entrepreneurship within our groups. And I think it's a big one. You never know what your own internal groups are working on sometimes and the the skills they may have, and being able to foster those mood shot projects or those one-offs that they may be insightful on, I think is a big thing I'd like to see myself personally invested in. And then also working with our own team members because everybody's got an idea, right? Everybody's got a thought they could bring to the table. You never know that could be the pivotable change to the current company culture or the current company product, just because somebody had a thought and spoke up and we took the time to foster and nurture that at the same time. So I think bringing that into the mix is important outside of just scaling and building the company. It's what are the thoughts and ideas that our employees are bringing in, right? Or the new new personnel that are coming from different angles with to help kind of support that. So that's what I would say.

Justin Reinert:

And what are you doing? What are you doing today to prepare for that future, to make sure that your people are practicing that entrepreneurship?

Justin Ramsaran:

Yeah, I think we've been essentially putting those basic building blocks in, right? We have open office hours, we put those in place where we go through product review and we say, hey, there's a feature that you think you can build upon, right? Almost like a hackathon. Let's just jam through it in a couple of days and see what happens. Right? Let's see if there's a product market fit for that solution. One of the good ones I think a couple of our team members came up with in the last week is why don't we start a podcast? One that's very focused on digital health and connectivity. And I was like, it's a great idea. I'm on one now, we're talking about it, and it's great. But there's so much information that I think all of us have to share. And I think that's the important part there. So it's been finding ways to give everyone an outlet, be it creatively, be it technically, right? Even be it any type of form that they're able to produce back more and generate their own skill sets and build. So that's been the current process so far.

Justin Reinert:

Yeah. Well, and I love the idea of a podcast. I have two podcasts, and I just love being able to connect with people and get insights from others. And I learn so much in the process, it's a side benefit that the rest of the world gets to benefit from the conversations that we're curating. For me, I learned so much and gain so much from these conversations. So I can imagine that your team would definitely benefit from pulling in those insights from other peers in the industry. I think that's really great. So if someone joined your company tomorrow, what would you want them to say about your leadership in five years? That's a good one, I think.

Justin Ramsaran:

I think I would want them to say that I always had an open door, right? There was no thought or idea that was ever shut down. We always try to work an idea all the way through to the finish, even if it didn't come out to anything. Supportive, right? I did, you know, maybe a stepping stone company that they start off with and moved on forward through, but I was supportive to help foster them, to see me as a mentor, to see me as somebody to help in the future for their own abilities. And then I think just being able to say that we had an actual relationship outside of just the work, I think is something I always try to look at, right? Is I want to know the people we're working with. It's not just about the work getting done. It's it is for sure. But I think outside of that, having an actual relationship that's personal and being able to deliver, you know, fathomably good EQ, I think is also tough and having to be maintainable on my standpoint. But I think that's one thing I would love to hear is hey, he did have good EQ, he did care not only about the work we were doing, but also about me as a person in that capacity.

Justin Reinert:

Well, that's great. And it it sounds like you're well on your way that you know people probably already say those things about you. So I love the the intentionality there and thank you for the vulnerability in that. Well, Justin, I've really enjoyed the conversation today. Thank you so much for joining me. If folks want to get in touch with you, what is the best way to do so? Best way is always LinkedIn, right?

Justin Ramsaran:

My email, I'm sure we'll share that as well.co. You could find me there and honestly, Google me. Right. Always an easy way to find each other now these days.

Justin Reinert:

Right. Well, thank you so much, Justin. I've really enjoyed the conversation.

Justin Ramsaran:

Yeah, appreciate it, Justin. Thanks for the time.