Building the Foundation at VillageMD
If you joined a healthcare startup in 2015 as one of its first employees, stayed for nearly a decade, and helped build its foundation from the ground up, you’d leave with a very different understanding of what it takes to make healthcare operations work.
That’s the path Steve Valdiserri took at VillageMD, joining as a manager and eventually rising to VP of Value-Based Strategies. His years there gave him firsthand experience with value-based care, healthcare operations, strategic initiatives, and the challenges that come with scaling a healthcare organization.
Those years also taught him something that continues to influence his work today: healthcare organizations can measure almost everything and still struggle to understand what actually matters.
Behind the dashboards and reports is an enormous amount of manual work. Data has to be pulled, reconciled, and interpreted. Payers have to be followed up with. Teams have to connect information from different systems to determine what is really happening.
That experience shaped how Steve approaches healthcare operations today.
From Operator to Advisor
After nearly a decade at VillageMD, Steve launched Avanti Strategy Group in 2025, a boutique advisory practice focused on helping healthcare and technology organizations solve operational problems, connect to the right solutions, and realize financial value.
Avanti gave Steve an opportunity to step back from day-to-day corporate leadership and look at healthcare organizations from an advisory perspective. Its work spans areas including value-based care strategy, revenue cycle management operations, AI-driven analytics, and healthcare innovation.
The experience sharpened Steve’s ability to identify where strategy and execution break down and determine what needs to happen next.
But consulting also reinforced something Steve already knew about himself: he likes operating.
His philosophy is straightforward: let the deliverables measure your value. The work matters more than the pitch, and execution ultimately determines whether a strategy succeeds.
That realization helped lead him to his next chapter.
Building Tally From the Inside
Today, Steve’s primary professional focus is Tally where he serves as SVP of Operations.
Tally is the AI and automation layer, that also has an RCM expert-led revenue cycle management service built around it. Steve runs operations across both.
His path to Tally came through two longstanding healthcare connections. A former VillageMD colleague who had begun working with Tally made the introduction, while Steve had crossed paths with Tally’s founder and CEO more than 15 years earlier at Accretive Health, where he began his career in revenue cycle.
What attracted Steve was the opportunity to turn strategy into operating reality.
Tally already had real clients and real revenue. The opportunity was not to build another strategy deck. It was to build the operating infrastructure that would allow the company to execute consistently as it grew.
As SVP of Operations, Steve oversees client success and delivery, operational readiness, client launches, and growth. In practical terms, the CEO focuses on strategy and the market while Steve runs the operating engine: the team, clients, systems, and execution.
He has built operating infrastructure, established systems and accountability, stood up the client success function, helped develop the operational and HR foundation for a distributed U.S. workforce, expanded existing client relationships, and launched new clients from end to end.
For Steve, that work is familiar territory. The difference is that at Tally, he gets to build the operating system from the inside.
A Different Approach to Revenue Cycle Management
One of the ideas driving Tally is that healthcare organizations shouldn’t have to choose between people and technology.
Traditional RCM businesses can add people when volume increases. Software companies can provide another tool and leave healthcare organizations to figure out how to incorporate it into daily operations.
Tally combines human-led RCM operations with automation built directly into the workflow.
People remain involved where judgment matters. Automation handles repetitive work. And because the technology operates alongside real production workflows, it can learn from actual claims and payer behavior rather than relying solely on a demonstration environment.
The goal is straightforward: improve outcomes and lower costs without requiring headcount to increase at the same rate as volume.
For Steve, that represents one of the most interesting challenges in healthcare operations today. If a healthcare operations company can scale without scaling its workforce at the same rate, it could change the economics for mid-market healthcare providers that cannot afford enterprise-level tools or large operational teams.
Where Experience and Execution Meet
Steve’s experience at VillageMD showed him how complex healthcare operations become at scale. Avanti gave him a broader advisory view of how healthcare and technology organizations approach those challenges. Tally now gives him the opportunity to apply those lessons directly.
Avanti remains an active strategy and advisory practice, but Tally is where Steve spends the majority of his time.
The two roles are complementary. What he sees across the industry through Avanti makes him better at Tally, while the lessons from operating inside Tally inform his advisory perspective.
Across each chapter of his career, the same principles have remained consistent: do the hard things, let the work speak for itself, ask questions, listen carefully, and stay level-headed when circumstances become difficult.
From helping build VillageMD’s foundation, to advising organizations through Avanti, to now helping build Tally, Steve’s career has increasingly centered on the space between strategy and execution.
Healthcare will continue to become more complex. Technology and AI will continue to evolve. But the fundamental challenge remains the same: turning good ideas into systems that actually work.
That’s where Steve has spent his career, and it’s where he is spending his time now.