Show Notes

Episode Overview

Angie Cosca’s career journey challenges every assumption about traditional tech career paths. Starting with no formal computer science education, she taught herself HTML using Notepad, worked her way up through help desk support, and eventually became CIO of a major healthcare organization – all while staying with the same company for 23 years.

Her story demonstrates the power of curiosity, relationship-building, and continuous learning in creating a successful technology career.

Key Takeaways

On Career Development:

• Formal education isn’t required for tech success, but continuous learning is non-negotiable
• Taking on responsibilities beyond your job description opens unexpected opportunities
• Building relationships across the organization matters as much as technical skills

On Leadership:

• Understanding business workflows and pain points enables better technology solutions
• Collaborative hiring processes involving other departments improve team dynamics
• Second opinions and diverse perspectives strengthen decision-making

On Healthcare IT:

• Technology professionals in healthcare indirectly save lives by ensuring reliable systems
• Vendor relationships should be partnerships, not just transactions
• AI implementation requires careful change management to avoid employee fear

Guest Background

Angie Cosca serves as Chief Information Officer at Steinberg Diagnostic Medical Imaging (SDMI), where she oversees IT infrastructure, compliance, and security for 12 locations serving 550+ employees. The organization processes approximately 500,000 diagnostic studies annually, including MRIs, CTs, X-rays, and ultrasounds.

Beyond her corporate role, Angie is President of ISSA Las Vegas and dedicates extensive time to mentoring through IT Works, a 16-week intensive program helping disadvantaged students transition into technology careers.

Resources Mentioned

• IT Works: 16-week intensive IT program for disadvantaged students
• ISSA Las Vegas: Information Systems Security Association chapter
• PACS: Picture Archival Communication System for medical imaging
• UNLV Negotiation Course: Referenced for professional development

Episode Highlights

• The Power of Curiosity: How asking “why” and observing workflows leads to better solutions
• Vendor Partnership Strategy: Building relationships beyond transactional interactions
• Mentorship Impact: The long-term relationships formed through programs like IT Works
• Healthcare Technology: Understanding the life-saving implications of reliable IT systems

Connect with Angie

• LinkedIn: https://www.linkedin.com/in/angeline-cosca/
• ISSA Las Vegas: https://www.lvissa.org/

TranscriptionManuel Martinez: Welcome everyone. My name is Manuel Martinez, and this is another episode of Career Downloads. Where each episode, I basically hit the refresh button and bring on a different guest to learn more about their background and their experiences, to really help uncover any actionable advice that you can use as you’re managing your own career. I’m excited for today’s episode because I have with me Angie Cosca, and she is a CIO here in, for the medical industry within Las Vegas. So again, I’m very excited to kind of understand her journey, where she kind of started and eventually how she ended up in her role. So with that, I’ll introduce Angie. Hi Angie.

Angie Cosca: Hi, thank you for having me, Manuel.

Manuel Martinez: I appreciate you coming on and being open to kind of sharing your experiences.

Angie Cosca: I’m excited.

Manuel Martinez: So if you don’t mind, can you just kind of tell us what your current role is and just some of the roles and responsibilities that you fulfill on a daily basis for the most part?

Angie Cosca: Sure. So I am currently the Chief Information Officer for Steinberg Diagnostic Medical Imaging. For some of the audiences that know what this is, it’s a radiology center. We have 12 locations here, and we handle about half a million studies a year. And the studies are your MRIs, your CTs, your X-rays, ultrasounds, a whole gamut of diagnostic images itself. So, and we also have over 550 employees as well. We have here with 12 locations. My main responsibilities really is the IT infrastructure, compliance and security. So as you can tell, I fight every day because you have operations and security, but I do manage the servers, the networks, computers, even the applications, we support all of that. At the same time, we also make sure that we are complying with PCI, HIPAA, and then security as well. I am also in charge of the physical security of the organization as well. Yeah, so a lot.

Manuel Martinez: Yes, it sounds like it keeps you busy.

Angie Cosca: It does, it does, yeah.

Manuel Martinez: So if you don’t mind now, kind of tell me a little bit about kind of where you grew up and then eventually what got you kind of interested or involved in technology.

Angie Cosca: Yeah, so I was born in the Philippines, but I grew up in Guam. So I’m not sure if you know where Guam is. It’s a little island of nowhere, pretty much, yeah. But for the most part, that’s where I grew up, all the way up through my early adulthood there. But I didn’t get into computers until college, which is the early 90s. I am completely aging myself now.

Manuel Martinez: We’re around the same age, so don’t worry about it.

Angie Cosca: Okay, so in the early 90s, I went into college during the freshman year. I wasn’t really touching computers until I was required to do it for word processing and stuff like that. But I wasn’t really interested in computers until the internet boomed at that time in Guam. The fact that you can go to the library and search the national libraries in the United States instead of just what’s in Guam, that was amazing because there’s so much information now that you can get. And then I think the IRC also boomed at that time. So just being in the middle of nowhere and being able to talk to people in the US or internationally, I was talking to people from the Netherlands and Spain. That was just very intriguing to me at that time. And I knew at that time when the internet boomed, it was like computers, the way to go. So I learned everything about computers then. I started building my own BBBs, playing Doom. Those are like my favorite past times is playing Doom with my friends. And instead of being on the phone for hours, I’m on the computer for hours, either it’s IRC or playing Doom and stuff like that. So that’s how my career started or at least how it piqued my interest in IT. I don’t remember how I met my previous boss then, but I was offered a job to do a website for Guam. It was a really huge website. We’ve never really had websites and because the internet just started. So it was a website for a huge telecommunications company. It’s similar to what AT&T is here to Guam. So it’s what everybody uses them for cell phones, telephones and all those services and stuff like that. So I was part of that team that actually built this website. So I learned how to code. I had to look at HTML coding, just looking at all the websites. Then they’re all basic websites that I’m researching, but I learned how to do everything through Notepad. Not fun.

Manuel Martinez: No.

Angie Cosca: But I knew I wanted to do some kind of web design work. So I went ahead and accepted the job. So I did my research, looked at every websites and just figured it out myself. Okay, how do you do websites? Okay, you need to do the heading here, blah, blah, blah. You need to have to do images here. And then I also decided, okay, I need to do graphic design too. If we’re gonna do a website, we’re gonna have to have good graphics. So I learned graphics myself too. All of these are self-taught. They didn’t really have really good books or online books at that time. So I taught myself that. I started sitting down with graphic students at the college at that time, the university in Guam. I sat down with them and I said, show me how to do some things. How do you blur this? How do you make this better, bigger? So I did all that and learned it all myself with Photoshop. Photoshop was easier then.

Manuel Martinez: Right.

Angie Cosca: Yeah.

Manuel Martinez: It wasn’t so complicated back then.

Angie Cosca: No, not like now. Yeah, but so yeah, it’s really self-taught because there’s not much resources then. But I loved it and I knew it was for me after I realized that I spent three days, no sleep, and I just wanted to get things done. And I was so happy to see the fruits of my labor after that. So that’s what got me into computers for sure, yeah.

Manuel Martinez: And when you were in college, what did you think you were gonna study at the time?

Angie Cosca: Oh, I was one of the students that had no idea what we were gonna do.

Manuel Martinez: Okay.

Angie Cosca: Yeah, as a Filipina, my mom always thinks I’m gonna be a doctor or a nurse.

Manuel Martinez: Right.

Angie Cosca: I hated biology.

Manuel Martinez: You’re like this is not for me.

Angie Cosca: It wasn’t for me, but that was like the standard for Filipinos there. You have to be either, but I knew it wasn’t what my future would be. So I just like, okay, I’m just gonna do basic courses and business management. That’s like the usual that people get, right? So I just did business management until I started getting into computers and I knew like, okay, I am gearing more towards computer. Now this is what I wanna do. So that’s when I started taking some computer classes as well. I started taking like COBOL classes, other programming languages as well and trying to learn databases. I took those classes, but it was fun. I loved it, yeah.

Manuel Martinez: And when you were self teaching yourself the HTML, right? Cause there weren’t good books, researching on the internet wasn’t, you know, the amount of information like we have now wasn’t back then. So were you just basically setting up your site and then testing things out like live? Well, I mean live like within your production saying, okay, let me tweak this and see what changes. I’m just kind of curious, you know, what the way that you approached learning this being self taught.

Angie Cosca: So what I did was I actually looked at, cause my boss at that time showed me a lot of the websites here in the United States that he said, okay, I wanna model it something like this. So I just looked at all of those websites. I looked at source code and I was like, okay, so this is how you start an HTML. Okay, let me do that here. So I said, okay, hello world. You know, I started with stuff just the words, you know, and then I started peeking it more, just changing it little by little until I like, oh, okay, so here’s how you do a menu. Here’s how you put an image, you know? So it was just, it was, one by one, I started learning how to design it properly. Yeah, and it’s all true notepad. I have a love and hate relationship with notepad. (laughing) Because of that.

Manuel Martinez: Oh because of that.

Angie Cosca: Yeah, yeah. So it was all through Notepad, but it was great because I also was able to research all the other websites. I knew that we needed something more than just words on a website. So that’s when I’m like, okay, we need to start putting graphics on here that will attract more people, you know, and even marketing stuff, right? Yeah, that can attract more people to the website. So it was all just research and looking at the source codes and stuff like that, yeah.

Manuel Martinez: So then you’re starting to take all these additional courses, you know, programming, database. Did you end up finishing your degree and then what did you think you were gonna get into getting out of that? Did you think, oh, I’m gonna be a full-time web developer? Were there programming classes that caught more of your attention? Or was it just, I am enjoying learning everything?

Angie Cosca: I really enjoyed learning everything. I did not finish college in Guam, nor actually here, I didn’t get to finish college. So I actually have no degree right now, but that’s okay. You know, completely okay. But I took any course that I was interested in. I think that’s why I was just very interested in everything. Like, oh, I like databases. Let me try this out. You know, I like Excel. Let me try this out. So whatever piqued my interest at that time are the courses that I took. And so I just took a bunch of IT courses and life happened. So I moved out of Guam and then I moved here in 97. Yeah, so I did the same thing here. Whatever courses I like, like, hey, I’m doing, you know, Linux now, or I’m doing forensics, or whatever interests me in that time is really the courses that I’m taking. Yeah.

Manuel Martinez: And I’m glad you mentioned that because I think a lot of times people think that they have to get the degree, or even if they start like, oh, I have to finish it. But I like the approach that you took. And even now you can still take formal classes at a community college, or you can take online classes. I think you’re thirst for knowledge and say, well, I just want to learn this. I want somebody to teach me and get me started. But it sounds like once you got enough from that class, you kind of built on it on your own. Is that accurate?

Angie Cosca: Oh, it is. Yeah, every time something interests me, like networking, I’d be just delving into networking, nothing else. Or system servers, I’ll just be delving into Windows servers and stuff. And that’s how my history has been with Steinberg Diagnostic where most of my employment is. I’ve been in 23 years with SDMI, so I grew, pretty much I feel like I grew up there. So whatever interests me, I’m going to get into it. So that is how I approached more of how my IT career is. I didn’t want to be just bolted down into one thing. And at that time, I liked web development, I liked graphics, I liked IT, so I was just doing each one. I’m pretty hands on with most of them, so I feel like a handy woman. You get it? Yeah, I can do all this. And I can be able to answer all of this, not just that one specific subject and stuff like that.

Manuel Martinez: So then now as you come to the US, what is it that you kind of, with the knowledge that you’ve gained, how did you approach getting your first employment here in the US?

Angie Cosca: The first employment here in the US, actually it wasn’t IT. I’m pretty sure you’ve heard of GameWorks. We had a GameWorks here on the strip before and they had a 75 foot indoor climbing facility then. So I was one of those person that was belaying and telling people, come climb thing. And if nobody was climbing it, I had to do it. So that was fun because it’s all physical labor and at the end of the day, you don’t have to worry about anything. But I did miss IT so much. So I actually started working for MicroAge as a help desk support in a call center. And it was great. I was supporting people who has UPS systems because UPS was providing actual computer systems for their clients before and for their big clients. And most of their clients were really farms. So I have some, such of the best funniest stories like their cow pee on a computer, how can they fix it? It’s stuff like, I don’t know how to fix that. Let’s try to wipe it down. Or they don’t know what a mouse is and stuff like that. So it was a lot of basic things that farmers didn’t know how to use a computer. And after that, the job in MicroAge, I realized I love helping people. This is great because I love hearing them be really thankful at the end. And you’re helping people. Now they’re like, I can now continue my business. I can now do what I need to do. And so it was great. And just allowing them to learn what computers are or how computers work. Because they just shipped computers and go, okay, here you go. Here you go. Yeah.

Manuel Martinez: And I’m curious your experience with the help desk. So similar to you, one of my first jobs in IT was as doing help desk. Now I’ll tell you kind of my love hate relationship with it. I disliked being on the phone all the time, like just constantly answering the phone. But what I did like is similar to you. I liked helping people. And it really helped me get better at being able to communicate how technology works. So like even now, like if I think about explaining it to my family or somebody that’s new or somebody like from the business side, not everybody has the same passion you and I do have for tech and knowing how it works, but explaining it to them in a way that makes sense to them, but also doesn’t make them feel like you’re talking down to them.

Angie Cosca: Yes.

Manuel Martinez: Would you agree that, I mean, is that kind of the same experience that you had?

Angie Cosca: Yeah, because you have to speak their language for them to learn, the PC. So you kind of have to kind of gauge this first. Okay, so where is their knowledge in computers at that time? As you speak to them, you’ll know. And then yeah, you can’t be condescending obviously because a lot of people at that time doesn’t know how to use the computer. So it actually taught me too on how to teach people to use things the right way, how to talk, like, okay, you haven’t used a mouse before? Don’t worry about it, I can show you. You have to be really nice to them and just show them that like, no, anybody can learn computers. So that is one thing that I learned from that job is that how to talk in a person’s level when it comes to IT. And until now, I still use the same approach. When somebody asked me how to use an application, I still do the same thing. How do I gauge where their knowledge is? And then I start teaching them to the best of my knowledge and how I can teach them how to use it the right way.

Manuel Martinez: So then what did you do kind of after that help desk position, did you kind of move up within there? Or are you picking up additional skills? What was kind of your next step to kind of grow out of that?

Angie Cosca: At that time, that call center, the pay wasn’t really that great. I loved it, so I stayed for a couple years. But I got offered a job to be back to web developing, which I just took it right away, even though I was working in my boss’s house at the time. It was kind of a startup, like a startup. So by I knew it’s web development, it got me excited again. So I said, yes, I’ll do it. It was for a local consulting firm at that time. And they had like, you know, just a few clients here. And one of the clients was actually my current employer, Steinberg Diagnostic. Yeah, so they hired me as their receptionist slash web developer. Yeah, so I was answering their phones, talking to clients, but I was also helping build up some of the company’s websites here. Steinberg being one of them. And we did some for casinos as well. We were helping build virtual casinos at that time. So that was fun. A lot of graphics in that one, because casinos, they love everything bright and bubbly and loud.

Manuel Martinez: Colors and flashy.

Angie Cosca: Yes, yes. And we also did help the website for the Little White Chapel at that time. That was one of our clients. Yeah, so it’s just, you know, a few clients there. Just helping out, we’re just a consulting firm that had a lot of clients and it was fun. You know, and I liked growing with that company because it helped me learn more about not just HTML. I learned ASP. I learned how to do real graphics at that time. You know, I got some classes in. So that’s why I liked working for that. They gave me the opportunity to learn and, you know, they gave me the opportunity to take some classes too. They helped me out with that.

Manuel Martinez: Oh really?

Angie Cosca: Yeah.

Manuel Martinez: Because that was gonna be my next question is, you know, how are you developing these skills? Are you continuing to obviously be a self-learner, but it sounds like they also supported you in taking classes, maybe buying books, things of that nature.

Angie Cosca: Yeah, self-learning is never gonna go away for me. I’m always gonna do that. So, but that was one of the things that they did. They bought me a lot of books. They really supported me. They gave me some help. They actually brought in another graphics designer because I knew I was kind of struggling with graphics. I didn’t think I was as creative. Say they brought in another graphics designer and we were helping each other out and teaching each other. I was teaching her more of the technical stuff. She’s teaching me more of the creative stuff. So that was fun when you have a team that’s working together to have a great outcome. Right. Yeah. So we did that for a few years. Wow. Until that company went down. (laughs) Unfortunately. Yeah, so what I did after that, actually I took some of the clients and did some freelancing work. Yeah, it wasn’t a full-time job, but it was something to make a living at that time. Right. I was just a student. So I was like, okay, I’ll do some freelance work. So I took those clients and I said, I’ll just continue to work. So I did that for about a year.

Manuel Martinez: Right, and then you’re still obviously continuing to grow your skillset at that point. Yes. Saying, okay, I’ll continue working for them. Like have some sort of steady income as you’re continuing to probably learn. And did you think at that time that you were, you started in web development, you kind of went to a help desk, went back to web development. Did you think that that’s what you were going to be, like was that gonna be your career path at that time?

Angie Cosca: I thought it was. Yeah. I thought web development is it. I’m like, this is what I’m gonna do. I loved it. I love seeing the results. And at that time, there’s so many people that wants their websites done. Yeah. You know? And I was getting more and more clients, which was great. I was starting to visit clients instead of working from home. So it was great until 9-11 happened. So that’s when everybody stopped spending any money on anything and websites. So it’s not one of those real needs at that time. So they stopped spending money on developing any websites. So I lost a lot of clients. And that’s when I was struggling, struggling to get a job. Well, 9-11. Nobody wants to hire anybody too at that time. Yeah, struggling to get a job, struggling to live as a student, is trying to pay for classes and still try to live and eat. So I was struggling at that time.

Manuel Martinez: And then obviously they’re not hiring for web development. It sounds like that was your strong suit at that time, but you have knowledge about a number of other technical areas. Probably also the necessity. You’re thinking, well, I’ll just, I’ll find a job to at least, like you said, I have to live, right? So to continue to live. So I’m sure that that was, that’s a struggle. And how did you kind of move forward? Because it sounds like it wasn’t just you, but you had a graphic design partner. Was she doing part of the consulting with you as well?

Angie Cosca: No, she moved away to California. But I knew from my experience, I had experience with MicroAge doing, I knew how to support people. I knew operating systems, I knew how to get around them. I knew programming, I knew some graphics. So I did have something under my belt, but it was just hard to get a job at that time. Luckily, my previous boss from that consulting firm, after that company went down, he went to work for Steinberg Diagnostic as their first CIO. So when I started talking to him and I said, I’m struggling, I need a job. Well, he said, well, Steinberg Diagnostic still needs their website done. So why don’t you work for me? So I was like, cool, I’ll work for you. I loved him as my boss. I’ll work for you, sure. So I did, so I started going onsite at Steinberg Diagnostic, eight hours a day full time as a web developer. But I realized shortly that I can’t do web development for one company all day long. I’ll be done in eight hours for the most part, or less than eight hours. And then I still have like the rest of the week, right? So what I decided to do is after I’m done with my work with web development, I didn’t like just sitting down and twiddling my thumbs. No, I was like, I need to do something. So I started walking around the facility saying hi to people. And I said, hey, Angie from IT, they go, oh, can you fix my printer? So they’re all started, so I said, I’ll fix it for you, so I fixed it. I’m like, oh, can you fix this? I don’t know how to use Word. So I started teaching them. So next thing I know, most of my time at Steinberg became like IT specialist. Fixing printers, fixing operating systems, setting up computers, going under the desk, connecting stuff, but I loved all of them because at that time, I was actually completing stuff. And people are happy, like, yay, now I can work. And I love how people are just so appreciative. It means just a simple plug it in, and like, you fixed it. I’m like, oh, I just plugged it in. (laughing) Okay. But I love how people are. And after that, they start depending on me and fixing all of their PCs and their computers. And I did that for a few months at Steinberg Diagnostic. Yeah.

Manuel Martinez: And I like that you didn’t just kind of sit around and say, well, I guess I can sit here and collect a paycheck, because to your point, right, once a website’s done, sure, there’s changes, but it’s not happening there.

Angie Cosca: Minor, yeah.

Manuel Martinez: All the time.

Angie Cosca: Yeah. (laughing)

Manuel Martinez: And as you’re going through and kind of walking around and meeting people, after you’ve been doing this for a few months, did they kind of decide to roll you into, like, an IT specialist type of role? Or were they okay with, like, well, at least she’s doing something else, not just web development.

Angie Cosca: Yeah. Yeah, I knew I didn’t want to just sit around. Yeah. I want to be busy when I’m working, you know? And I want to be able to help out the company in whatever way I can. And it was IT at that time. So I think it was just a common knowledge that I was the IT specialist eventually when I’m always just walking around and helping people. But even though my actual role at that time was a web developer, I think I’m more of an IT specialist. Yeah. So it was fun. I loved it. We had several locations, too, at that time. So I was able to travel from one to another. And, but after a few months, that same boss actually offered to promote me. He pretty much set me aside and go, “Hey, you want to be a PACS administrator?” “Sure.” And then I took him, like, “What the hell is PACS.” (laughing) But, “Sure.” You know, I’ll do it. I knew, I just, whatever it is, I want to learn it.

Manuel Martinez: Right.

Angie Cosca: You know, because as long as it’s in IT, I wanted to learn it. So PACS, if, for some that doesn’t know what PACS is, it’s a picture archival communication system. In the old days, when you have X-rays, you have those films. And those films are very expensive. Not only to purchase, but also to discard because there’s so many chemicals in them. And it’s storing them, because here in Nevada and HIPAA laws, you have to store them for, depending on what the state laws are, seven to 10 years, depending on how age a person is due. So we would store all these too as well. So we have a warehouse full of these things. So the PACS actually was a great, you know, innovative solution for that. You will no longer need those films. Everything is on a medical grade monitor. So I learned how to build the servers. I learned how to make sure the network is proper as well. I learned how to build the workstations, how to install the application. And then after that, I also learned how to support it. Yeah. I was the first PACS admin after that, which is great. I loved it. I was the liaison between the radiologist and IT and technologists and IT. And I also did a lot of the training. So I pretty much did everything as far as the PACS admin. I trained radiologists. I was their 24 hour hotline. Like, oh, I can’t do this and stuff like that. Same thing with the technologists as well. Also storage. I was maintaining storage too, because these are like tons and tons of storage. So I did everything from servers to workstations, to supporting. It was a great career.

Manuel Martinez: And was that because, I guess one of the things I should have asked was, how big was the team? Was it really just your manager and you? It sounds like you were a one person team. Is that accurate?

Angie Cosca: There’s three of us. There’s a CIO. And then there’s a risk administrator, where we try to keep him in this cage. He’s a coder, but he’s got a mouth. So it’s like, okay, you stay in your cage. So I’m the one that’s kind of the liaison. And I said, okay, the risk administrator, people need this. And then he’ll be like, ah, blah, blah, blah, blah. You know, he’ll be like complaining. Like, no, you gotta do it this way, because this is how they want it. This is how they want the GUI to look like, because it works better for them, for the workflow. So I was that liaison as well for the risk administrator. And then my CIO, he takes care of all this strategic stuff. So really, I’m one of the first main support person there until we hired another person to help me out. Yeah.

Manuel Martinez: And I’m sure that that had to have been a lot of fun, like learning PACS, understanding how those, that digital imaging for that, because it’s not the same as just like a regular picture. And I think that’s the things that people may not understand is I’m guessing that it’s coming from, you know, whatever X-ray or medical device it’s going through. Yes. You’ve mentioned, right? It’s gotta go across the network. And then now we have to be able to store that image and retrieve it through some sort of system on this medical grade device. So.

Angie Cosca: Yeah.

Manuel Martinez: Are you attending courses? Did they have a vendor kind of come in and help you? Because I can imagine that that’s not easy to set up by yourself. I mean.

Angie Cosca: No, no, not at all. They’re great. They sent me to Vancouver for training to learn everything from the ground up, even how the architecture works, how the database works. So I was able to learn that. At first the company wasn’t gonna give me that much information. They were just gonna help me set up servers, but I wanted to know everything. So I actually stayed a couple of days and I said, “No, you show me how that database works.” Or, “How are the tables? What are the structures?” I wanna learn why our image is not showing up properly in certain ways. So I spent a lot of time with their help desk too, so I can learn what issues that we’re gonna be expecting once we bring up the system. So I sat down with their help desk and listened to some of their calls. And I wanted to know, “Okay, what do you do with these issues?” And I also wanted to meet the people that I’m gonna be calling when I’m gonna need support. So I think it was great that they sent me up in Vancouver to learn all of that. I think I spent a week and a half there just to learn everything and it was great. And then by the time I got back, we just had a few weeks and we got all the system set up. And within a weekend, we had a new PACS system. Obviously it’s still new, so there was still some issues. But just learning all the ins and outs of the system and just willing to do all of that is actually something I think everybody should do. If you were planning to support a system, learn everything about it. Not just because they gave you something and you just learned by the book, whatever they gave you by the book. I actually talked to the service manager and I said, “No, I do wanna sit with your support.” They don’t typically do that, but they did it for me because I think I was very persistent at that time. Like, “No, I’m here for another day. Let me spend some time with you.” You know?

Manuel Martinez: And you mentioned, right? Because it is a newer system. You’re gonna have to call them at some point. So I don’t, you probably weren’t actively thinking about it at the time, but it helps you establish a relationship with the help desk people. Because now when you’re calling, they’re like, “Oh, hey Angie.” Yes. It’s not just, “Oh, it’s Angie that calls all the time.” It’s, “Oh, Angie that I met, that she sat with us and we got to know each other a little bit.” So that probably helped too, as far as they’re a little bit, not that they wouldn’t be willing to help you anyway, but now there’s probably a little extra incentive because–

Angie Cosca: Yeah, and you know them kind of face to face. You have a face so that you can, “Hey, yeah, I met you. Yeah, it was great meeting you, but hey, I have a problem.” And then you’ve already established that between the two. Yeah, and that’s what I loved about it. So I kinda knew for the first year at least, and you the people that I’m calling within that support group. And actually I’m still friends with some of them. This is how that started. I started becoming friends with all of them because we’re always on the phone. Right. And the next thing you know, when they come here, because once in a while they visit us, we’re like, “Hey,” and then it became a friendship.

Manuel Martinez: That’s awesome.

Angie Cosca: Really good.

Manuel Martinez: And I love that. I love that it wasn’t just a work transaction, right? Like eventually, again, you get to know people, especially if you’re talking all the time.

Angie Cosca: And that’s a huge part of that. You have to have that relationship with the people that’s gonna be supporting you. And that’s why I always tell people, when you’re looking for a vendor, you look for a partner. You don’t just look for transactional, you look for a sales rep who’s gonna be there with you the whole time, not just when after you sign, you won’t see me need somebody that’s gonna be there throughout the whole time. You need to meet the people who’s gonna support you. So I insist on meeting some of the people that supports us. So those are just big things that I realize that you need to have this for a system, mostly for healthcare systems that’s very important. You need to know who the people are that’s gonna help you out.

Manuel Martinez: Wow, that’s cool. I mean, it’s exciting to see, and again, probably at the time you weren’t thinking about, you’re like, “Hey, I just wanna learn, I wanna meet these people and understand who I’m working with.” So now you come back, you’re implementing this, you have a good relationship now with your vendor, you’re the PACS admin slash IT support, and kind of what do you decide to learn next? And I’m gonna say learn next, because my guess is that once you got pretty familiar you’re in the system working, again, it’s probably back to like, “There’s problems, but you understand it and what was your next challenge?”

Angie Cosca: Well, you know what’s good about PACS? There’s always something new. So I don’t think I ever had to tittle my thumbs with PACS, so I did PACS for 10 years actually. It’s a great career, I loved it. If I ever have to go back to it, I would. So I’m managing the PACS team too, by the way, right now. Sometimes I hang out with them, because I’m like, “Okay, let me learn this.” But one thing about good about PACS is because it’s healthcare, there’s always something new. There’s a new technology coming out. There’s a new X-ray system coming out that you need to make sure that shows properly in the system. There’s still a lot of issues that you have to deal with, and that’s what’s great about IT, right? It’s not just new healthcare technology. There’s always gonna be new storage systems coming out. There’s a new operating system that now you have to implement and upgrade everything, or there’s a new antivirus system. So that’s what’s great about IT. There’s always something new. So I wasn’t bored at all, and I love being in PACS. Like I said, it’s a great career. If anybody wants to get into healthcare, PACS is one of them, because the hospitals use them. And a lot of even dentists use them. So it’s pretty widely used. So it’s great. I did it for 10 years, and I loved it, but there was a point where like, “Okay, I think I’ve done a lot of PACS.” There was a time where I thought, “Okay, I think I need to do something else.” I mean, not out of IT, but something else. Right. Right? So that’s when I talked to my boss, and I said, “Okay, is there anything else I can do?” And then he started talking about, “Well, what about managing the team?” Because there’s also a network team and a sysadmin team, which I have a great relationship already at that time. Because we kind of grown. I wasn’t the only PACS admin at that time. So the team has grown. We have like a whole network team and other stuff already. So he goes, “Well, you have a good relationship with them. How about you manage them? Be the director.” It’s like, “Sure.” Even though I’ve never managed people before. I was like, “Sure, I’ll do it. I’m still in IT.” So that’s great. So yeah, I started managing, became the IT director. I got promoted. I was managing about six people at that time. And it was everything, not just PACS, but it was everything as far as the phone system, because we had a voiceover IP system. We had the phone system. There’s a new dictation system for PACS that we were implementing. There’s all these new technologies coming out at that time too. So it was great managing the team, but also not as great, because I’m not in the weeds as much as I want to. And I love being in the weeds. Right. And being in management is more political. So there’s that difference that I think I didn’t really like the political stuff. I really wanted to be in the weeds, but I also wanted to learn how to be in management. So that’s why I said yes to management.

Manuel Martinez: Got it. And that was gonna be my question, is what is it that attracted you to the management side? Because it sounds like you have this thirst for technology and learning new things. And yes, management is something different. You are learning a new skillset, but it’s not necessarily, like you said, it’s not a technology skillset. It’s more soft skills, more people management for some of the politics. Did you think about that when you took the role or you’re just like, sounds like a new opportunity. I’m ready for something different. And you just kind of went in full force and said, I guess I’ll figure it out.

Angie Cosca: Yeah, I think it’s like PACS, I just went full force. I’m like, sure, I’ll do it. I’ve never managed before, I’ll do it. But I knew, just because it’s a whole new set of skills that I have to learn, I think that’s what it is. I love learning. I haven’t mastered all of IT, but I do love learning something new. So I learned how to manage people the right way. I learned, I know how to talk to the other leaders at SDMI at that time. And I learned how to align IT with the business goals. That was part of the hardest part. Because you’re so technical and like, no, it has to work this way, blah, blah, blah. But now I learned what makes them fit. How can I get the two to communicate better as far as the leaders and as far as the technical team? So that was the one main thing, is making sure that both of our goals are being aligned, which was kind of hard at that time.

Manuel Martinez: And is that something that you learned, like was your manager, your director, your CIO, was he helping you kind of understand that? Are you just kind of having to slowly figure this out on your own? Because in my experience, the times that I’ve had to do that, I’ve been lucky enough to where there’s somebody to kind of slightly support me. Like when I was an individual contributor, right? And I was like, hey, we got, you know, similar to you, I was excited about the tech. I wanted to talk, well, we can do this and it will do these things. But then I’ve had those directors that are like, well, yeah, but it’s not helping the business, right? Or the business wants this done and that technology, yes, it’s great, it can do a lot of things for IT, but there’s no time, there’s no relationship to the business. So they’re not gonna wanna fund that. So how did you kind of learn to align that? Is it just talking to these other managers? Do you have kind of your director also kind of helping you out?

Angie Cosca: I had some slight help, but I also knew that, I had some slight help, but I also knew that I had to go out there and talk to every manager, which I did. I didn’t just like continue as a director and continue everything as is. I knew that I had to learn, other departments, I have to learn what front desk does, what’s their workflow. And because a lot of our work is really, how can we make their lives easier, each division, right? So I went to front desk, I went to the technologists, each division as well, the MRI department, the CT department, like, how do you do your things? And then I ask all the questions, why are you doing it that way? Because I can make it easier for you. And it could be the best thing in the world. They can say, no, you have a bad idea. But it’s just talking to them and spending time with each one, for example, with the front desk, there’s a lot of things that people just do because they’ve been doing it for years, right? Right. Yeah, no, because this is how I know I’ve been doing it. Well, with IT, you can actually make them even more efficient or make their workflow, you know, more seamless. So a part of it is just observing. You don’t have to say anything, just observe and see how everything goes. Ask all the whys, like, why are you doing it this way? And just learn it first before you start saying, okay, we can make things easier for you. Okay, well, now when you start getting your answers as far as the whys are, like, yeah, I’m doing it this way because for this reason, blah, blah, blah, I need the results to be this way. You have to understand it fully before you provide all the solutions. So that’s what I did for the first few months as a director. I went to each department and go, okay, but I just wanna learn. I just wanna learn, tell me your pain points. I always say top three pain points. Right. Because if you have any more, they’re gonna tell you 100 pain points. I wanna focus on the big ones. Tell me your top three pain points and show me what your workflow is. So I went to each one. We have about 20 departments, so I went to each one, spent time and then obviously write up my own report for myself so that I can remember what needs to be done. And then I presented some of the solutions to the other managers and say, here, here’s how I can make things easy for you. Here, I can, how I can fix things for you. And I still do that to this point. To this point, I still visit because things change. Workflows change. To this point, I still visit and go, how is everything? Why are you doing it this way? What can I make, do make it easier? What are your top pain points? So yeah, I’ve been with Steinberg for 23 years. So until now, I’m still doing that because it’s important that you still go there and still see how everything’s doing and still kinda see what you can do to improve. There’s always gonna be some kind of improvement, mostly with all these technologies and AI coming out now to help out, right? There’s always gonna be something that’s gonna be able to help out the business. And I also spent time with the leaders as well, not just with my CIO to find out what his goals are. I spent time with the other leaders and go, okay, so what are your goals? What are your expectations for my team? I know you talked to my CIO, but I would like to hear it myself. And what are the company’s goals and strategies? Cause you gotta learn all that before you start implementing anything. So I spent so much time for the first few months with so many people before I can say, okay, let me see what I can do to help everybody out now.

Manuel Martinez: I was gonna say up to this point, but I’m gonna say actually, probably throughout your whole career, do you think that that’s what’s helped you be successful and again, everybody has their own definition of success. But to me, successful is the fact that you didn’t take the information that you had and said, okay, I’ve got these grand ideas, but you always seem to be one, open to talking to everybody, right? So even if it’s just, hi, hello. The other thing is that curiosity isn’t just in technology, but it’s understanding like, well, what’s this workflow? Being able to ask all these questions and actively listen. Because to your point, I think a lot of times, and I’m guilty of it, I’ve done it where, are we asking and listening to answer or are we asking and listening to understand? And it seems like you are very good at listening and asking to actually understand. Is that something that you think is just born within you? Like it’s just that curiosity of really wanting to know or is that something you think over time you’ve slowly developed? Because I think I’ve gotten much better at it, but I know that early on it was, once I heard enough, I was like, oh, I had the answer.

Angie Cosca: I was the same way. Because you always wanna fix something, right? Because like, yeah, I got the answer. I can fix it for you. But I learned throughout the times, as I talk to many people, I knew that, okay, I need to listen to them. I need to have that relationship so they can open up more to me. So I started with that and I realized throughout the time, too, I can’t fix everything unless I completely understand what their issue is. Unless, for me, I can’t understand unless I see it. That’s what I always tell my people. I need to see it. Can you show it to me? Because sometimes if you don’t see it, sometimes their description is different from what you think it was. So for me, I’m always like, okay, I need to see it. Can you show me? So I sit down with that department. Can you show it to me? Even the clinical part. Sometimes I don’t understand when they say, okay, here’s the arm, it’s broken. Can you show it to me? Because I don’t see it. So I always love examples. I always love also being able to recreate things. So it’s easier to fix it that way. If you’re able to create it, you can fix it. So yeah, I learned it through time. And I think I was just like you. I just jumped into it like, I can fix that. Yeah, I was like that too at first until I realized like, okay, that’s not gonna work. Because that’s when people go, nope, don’t touch. That’s how people are like, no, don’t fix it. You’re just gonna break it, don’t touch.

Manuel Martinez: And how did you, do you think that also as part of that, you’re establishing that trust? Because it’s maybe because you’ve been there a little bit longer and they know you, but you’re still, maybe it’s somebody that’s newer in that role. You still have to establish trust because I remember asking people the same thing where they would have a problem. Like, I’m gonna go back to like as a specialist, right? Helping with PC repair and they’re like, hey, well, can you show me what you did or what happened? And there was that initially that almost like a fear of, oh, if I tell them, then I’m gonna get in trouble. Or if I tell them, they’re gonna be like, why did you do that? But I was like, hey, I just, I wanna understand. So the approach I took it is like, listen, I don’t care what happened or I don’t, I just need to understand. If you can show me as best to your knowledge, to how you remember, I go so that I can fix it faster. I don’t wanna sit here for an hour trying to reverse engineer something I have no idea. If you can tell me, I can be out of your hair in five minutes and move on.

Angie Cosca: Exactly. You have to build that relationship. You have to build that trust. Because there will be people who’s not gonna be willing to show you, or people that’s not gonna be willing to share what their goals are. Because if they don’t trust you, they won’t. So you have to build that trust first. So I actually feed on that. Just meeting the people, meeting my fellow management, not just management, even anybody. I feed on that and go, hey, just talk to them. Just a quick, easy talk with them, seeing how their day is and smiling at them, that works. But with the people that I know I’m gonna work with on a day-to-day basis, you gotta build that relationship for sure. And I love it too, because I’ve been with Steinberg for so many years. Some of these people I feel like I’ve grown with because I started in my mid-20s with SDMI. So I’ve been friends now with them. These are people that I care about, that I love. And it’s just that relationship and that kind of caring feeling that you felt for them, because you’ve been with them eight hours a day, really. So you gotta at least enjoy being with them. So build that relationship. So that’s important.

Manuel Martinez: They almost become a second family at that point. Because like you said, eight hours a day, sometimes you’re probably, especially in IT and healthcare, you’re probably spending more time there than you are at home.

Angie Cosca: Yes, sometimes longer than eight hours a day.

Manuel Martinez: Exactly.

Angie Cosca: Yeah, so they are my second family. So that’s why I love having a relationship with everyone. And building that trust is very important.

Manuel Martinez: So then in this role, apart from what you’re doing internally, because you’re a director, you’re also now probably also starting to deal with partners and vendors.

Angie Cosca: Yes.

Manuel Martinez: So how are you managing those relationships as well? Because you’ve gotta kind of go through, it’s a little bit different. Internally, you can, because you’re spending so much time there, you can build that relationship faster and really understand who’s trying to help me, who’s not, from the vendor standpoint, how do you go through and really understand? Are you doing the same approach? Are you asking them a lot of questions? Well, what happens in this situation? If we have this, how are you gonna support me? Like how are you managing those external relationships?

Angie Cosca: Yeah, I can tell you vendor management is one of the hardest things. Okay. (laughing) Manuel Martinez: Yes.

Angie Cosca: Because they’re completely different from Steinberg. Their goal is so completely different from Steinberg and stuff like that. But I did do the same thing. I met with each one of the major vendors that we were working with, had some meetings with them, talked about what our goals are, what my expectations are as far as supporting. My expectations is them being a partner, not being just transactions, stuff like that. But that is exactly what I did. I try to understand each vendor. I try to understand who my sales rep are, who the sales manager or the support managers are, because they are the ones that, by the time issues come to me, I need to be talking to either support or their leadership. Because most of the time, I let my team deal with the support team, right? So by the time it comes to me, when issues arise that they can’t seem to fix, more complex issues they can’t seem to fix, that’s by the time it comes to me and they ask for help. So I need to know who the support managers are, who I’m gonna be dealing with. I also try to learn who the leadership are. If I can go any higher than just a support manager, I try to meet them as well, because it’s best all just in case, right? So in learning vendor management, I do say it is one of the hardest things, because sometimes you’re fighting tooth and nail to get things done. And your goal is Steinberg, but I understand they have other clients to deal with as well. So, but my goal is Steinberg here. I need to make sure things are working for SDMI. So I hate the fact that sometimes you have to fight tooth and nail for things to get done, but it is what it is. That’s part of management, right? That’s why my people come to me and say, I need your help. They always say, okay, time to nag Angie And that’s what they, I was like, all right, I get to nag, you know, there’s stuff like that. But yeah, they mean vendor management is hard, but it’s also, you’re just gonna have to learn it. It’s the same thing, relationship. Learn who the people are, learn who the players are, and get to know. Have lunch or dinner with them, or have a meeting with them inside and just talk about, you know, what your expectations are. You know, talk about all the systems that you’re dealing with, all right? I also have to deal with them as far as negotiating the cost, right? And stuff like that. So I started doing that as a director as well. I started talking about cost, which is one of the hardest things. I’m not a negotiator, you know? I wasn’t at that time, but I learned how to, by watching my bosses, you know, I’m watching my CEO and watching my CIO and COO and how they negotiate. I learned that part. At first I was like, I’m not a negotiator, I won’t do it. But they’re like, you’re going to have to learn it. I was like, okay. So I just watched them. And it took years for me to learn to get to where they are, but eventually, you know, I’ve learned how to negotiate the right way, you know? And I’m still learning, you know? I even took a class in UNLV and how to negotiate because I’m like, I don’t think I’m there yet. You know?

Manuel Martinez: Yeah, and I don’t think we’ll ever be, we’ll ever be 100% comfortable or say that, hey, we’re the best. You and I seem to have that same, like, that thirst of like, okay, I’m better, but I can be better still, or I can learn more.

Angie Cosca: Yes.

Manuel Martinez: And I, you kind of answered the question as you were speaking is, they brought you into the negotiation, so you were able to kind of understand and see how they managed it. Sounds like that was a big portion of how you learned.

Angie Cosca: Yes.

Manuel Martinez: Okay.

Angie Cosca: I learned how they negotiated, which is great. They got guts. I didn’t. I was a shy person. I was a shy, quiet IT person until I started learning from my leaders, you know? And so they started showing this is how you negotiate. You know, they pretty much tell me like, okay, we won’t go for this cost, blah, blah, blah, you know, and finally they said, okay, here’s the vendor, negotiate. Let me see how low you can go with them. Let me see what you can get. It’s gotta be a win-win situation, right? Get a win-win situation with this one. I didn’t do a great job, but I learned eventually that I can, you know? But the good thing is that my boss was there to kind of watch over me, and he took over after. I couldn’t do, but that’s just how it is. I’m more like shadowing him at first, shadowing my CEO, and learning the ropes on how to negotiate, but I knew that that wasn’t just it. That’s why I went to UNLV to learn it the more official way on how to negotiate. So UNLV taught me more about the theory part of it, because they were learning me hands, I was learning from the hands-on part, but I’m learning the theory, like, okay, this is really the proper way you negotiate. This is the psychological way, right? And how to negotiate with somebody. So I learned that part from UNLV, and I learned the hands-on part from my leaders at Steinberg, yeah.

Manuel Martinez: And it sounds like the culture that they’re building there, right, is teaching you, getting you involved, making sure that you’re learning, and that’s gonna kind of lead me into the other area that as the director, are you involved now at this point in hiring, kind of building your team, and what’s the process that you kind of learned as far as hiring goes, right? Because that is something, I’ve only been in management once, and where I had to go through in interviews and understand how to filter, similar to like in podcasting, and asking the right questions to get the type of information that you’re looking for, not just are they technical, but what’s their personality? So how did you go about learning that? Was it the same thing where they’re bringing you in as part of a panel? Are they just, you go ahead and hire who you want, and you’re having to learn, you know, by trial and error, like, oh, I made a good hire, oh, I made a bad hire.

Angie Cosca: Yeah, I mean, it’s a lot of trial and error too, but before we hire somebody, our process is, we have a process right now. My team, whoever’s gonna be working with that person, let’s say IT specialists, so my IT specialist team, and some people from the other teams, will do the technical interview. The first interview is always gonna be technical, just to see if they are at that point for that position. So they do the first interviews for the first whatever candidates that, they also review the resumes too as well. They do all the first reviews, first interviews. By the time it gets to me, it’s usually the top five, maybe 10, depending on how good the candidates are. By the time they get to me, it’s all about the learning, their behaviors, their attitudes, how they are, so I don’t ask any technical questions, because I know my team asked the great questions. But I also bring in other managers, not just me. I bring in other managers from other departments, most of the managers that deals with IT a lot, those are the ones that I bring in, because they’re the ones that’s gonna be seeing this person on a daily basis. So it’s not just me interviewing, they are part of the interview process as well. And it’s also good to have good feedback from other managers. So that’s why I always say, so the second part will be me, just seeing what their nuances are, will they fit with the team, is the dynamics good? I can probably see it, but the others probably didn’t see it, that’s why I need their feedback. So that’s how I do my interview process, is by the time it gets to me, I’m already looking at, see how great their dynamics would be with my team. Yeah.

Manuel Martinez: And what is it that made you think of bringing in these other managers? Because you’re right, they’re probably gonna be dealing with them probably more often than they were with you. I never would have thought of doing something like that. So I just, what, is that something that was already established? Is that something you decided to come up with? How did that come about?

Angie Cosca: We just came up with that because we needed, I didn’t want to be the only person to talk to the candidate. I didn’t wanna be, I always like having a second set of eyes. I always tell people that. I would like to have a second set of eyes, anything I do, can I have get a second set of eyes? So the others are my second set of eyes. These are managers that’s done hundreds of interviews for their division. These are managers who have a good judge of character. That’s why I brought them in as well. And these are managers also who deals with my team on a daily basis. So they know how my team’s nuances, they know how they behave, they also know the dynamics will be great because they see them on a daily basis. That’s why I bring them as well. They’re my second set of eyes. They’re also there to keep me grounded because I might be like, “Oh God, I love this guy.” Blah, blah, blah, blah, blah, blah. But they’re like, “Wait a minute, you gotta watch this part because that was a red flag.” And like, “Oh, I didn’t see that.” Okay, it’s a good thing that they saw that part. So I always like to have that second set of eyes. Yeah, and just getting others feedback, it’s always great.

Manuel Martinez: And I like that. I like the fact that you are, I don’t know if I wanna use the word humble, but that you are open to understand that, hey, I might have, I might miss something. I wanna get that other feedback. The ultimate decision is yours, but you don’t take it as, okay, well, I’m the one making the decision. What does it matter, right? So it’s that openness to say, all right, well, this is a collaborative effort. Wow, that’s, I don’t know that I’ve heard that very often. So that was just, I mean, I’m sure it happens, but again, I just, I haven’t been involved much in that process other than once or twice. It’s eye-opening to kind of get–

Angie Cosca: I mean, it really works well for us, because like I said, they’ve interviewed so many people too, and I’ve seen them, the people that interview, and the people that they hire, they’re such good judges of character. Sometimes I don’t see what they see as well. So I’m like, let’s make it a group event, let’s do it.

Manuel Martinez: You’re like, I know my strengths, and I know your strengths, so let’s combine.

Angie Cosca: Yeah, let’s make it fun, yeah. And like you said, it’s a collaborative. They see things that I don’t see. They’ll see your red flag, they’re like, oh, I didn’t noticed that. But now then you tell me like, you’re right, that was a red flag, okay, let me think about that.

Manuel Martinez: For going forward.

Angie Cosca: Yeah, so it’s great, yeah.

Manuel Martinez: So you’ve been in this director role, it sounds like you’re learning a ton of new skills. How long ago did you end up moving into the CIO role, and kind of what was, was it a transition going from a director to a CIO? Because you’ve been there for so long, you’re understanding a lot of the tasks that they’re doing, so what was that transition like?

Angie Cosca: I think it was just a natural transition. When my CIO at that time moved on to bigger and better things, I think it was just that natural transition, because I became the acting CIO at that time. It was just natural. I got the tribal knowledge of SDMI, I started from the very bottom, moved my way up, and stuff like that. So it was just that natural thing to be the CIO. I’m already managing the team anyways. And I’m already very involved with everything as far as vendors, the systems, and the team. So I think it was just that natural progression. So they promoted me to a CIO in 2019. And it’s, oh, that’s a long time ago. Well,