COO - 64524627339

Somewhere•New York, NY

5d•Remote

About The Position

The COO is the senior operating executive of the business. This person will turn company strategy into a disciplined operating plan, integrate the work of existing functional leaders, and build the systems required for the next stage of Growth. This is not a chief project tracker, a caretaker of the current business, or a consultant who produces recommendations for others to implement. The COO must be able to run the current company and design the next version of it. The role requires decisive judgment, financial and operational fluency, comfort with incomplete information, and the ability to convert repeated effort into durable infrastructure.

Requirements

Operating leadership at scale: Substantial experience leading multiple operating functions in healthcare, health technology, insurance-based services, or another regulated, people-intensive organization.
Builder evidence: A record of personally designing and implementing operating systems, not only optimizing mature ones or sponsoring work performed by consultants and vendors.
Financial fluency: Meaningful accountability for a P&L, operating budget, revenue performance, margin, or comparable financial outcomes.
Healthcare operating depth: Working fluency in insurance-based healthcare operations, including revenue cycle, credentialing, payer dependencies, and the operational realities of supporting clinicians.
Executive judgment: A record of making difficult decisions with incomplete information, setting priorities under pressure, and correcting course without defensiveness.
Leadership strength: Experience managing senior leaders, addressing underperformance directly, and building teams that operate independently.
Data and AI fluency: The ability to use operating data, work effectively with technical leaders, define requirements and acceptance criteria, and drive adoption of automation or AI-enabled workflows.
Founder partnership: The confidence to disagree directly and constructively with a strong founder, then commit fully once a decision is made.
Communication: Clear, direct, low-ego communication across clinical, technical, financial, and operating teams.

Responsibilities

Translate company strategy into a limited set of annual and quarterly priorities with clear owners, milestones, metrics, decision points, and completion standards.
Establish the leadership cadence, operating scorecard, decision framework, escalation rules, and accountability mechanisms that keep priorities visible and moving.
Ensure that meetings produce decisions and commitments, that commitments have one accountable owner, and that unresolved issues remain visible until they are actually closed.
Separate urgent problems from important constraints. Prevent the company from confusing activity with progress.
Integrate clinician operations, revenue cycle, credentialing, recruiting and people operations, intake and access, technology, and other operating functions into one coordinated system.
Resolve cross-functional conflicts and tradeoffs at the operating level rather than pushing routine decisions to the CEO.
Clarify ownership wherever work is duplicated, fragmented, or dependent on informal influence.
Own company-wide initiatives that cross multiple functions or do not fit cleanly inside one department.
Design the organizational structure, staffing model, workflows, controls, and management systems required to support 300 or more clinicians without proportional administrative growth.
Lead operational readiness for expansion into Florida and subsequent states, including payer, credentialing, staffing, policy, technology, revenue cycle, and clinician-support dependencies.
Build a repeatable expansion playbook so each new market compounds the model rather than creating a separate operating island.
Lead the nonclinical operating plan for psychiatry and other new capabilities, with clear launch criteria and accountable owners.
Own operating performance and P&L discipline in partnership with the CEO and finance resources.
Build reliable visibility into growth, revenue, margin, capacity, utilization, clinician retention, client retention, access, and operational risk.
Use data to identify constraints, allocate resources, distinguish isolated events from systemic failures, and determine whether initiatives are producing the intended return.
Connect operating decisions to financial consequences. Do not accept reporting that only describes what happened.
Hold the Head of Revenue Cycle and other operating leaders accountable for measurable outcomes, workflow visibility, vendor performance, cycle times, and structural improvement.
Ensure that denials, aging, eligibility failures, credentialing delays, and payer issues are analyzed by root cause rather than repeatedly handled as isolated cases.
Build early-warning mechanisms, escalation standards, corrective-action plans, and verification so recurring failures become system improvements.
Maintain continuity and cash-flow protection during vendor, system, payer, and expansion transitions.
Partner closely with the CTO to prioritize technology against the company operating plan and measurable business outcomes.
Define operational requirements, acceptance criteria, workflow ownership, adoption plans, controls, and ROI measures for AI and automation initiatives.
Determine which work should be automated, redesigned, delegated, eliminated, or retained as a human judgment process.
Own operational rollout and adoption. The CTO owns technical architecture and engineering execution; the COO ensures that the organization changes how it works and realizes the intended value.
Use BigQuery and other reporting systems as decision infrastructure, not as passive dashboards.
Lead and develop the nonclinical operating leadership group, including the Senior Director, Clinician Operations and other assigned functional leaders.
Clarify decision rights, remove overlapping ownership, identify capability gaps, and build a leadership bench that can operate without constant founder intervention.
Set clear performance expectations, coach where development is warranted, and make timely personnel or structural changes when expectations are not met.
Build a culture that combines respect and emotional intelligence with speed, standards, directness, and accountability.
Create a high-trust operating partnership with the CEO. Challenge directly, use evidence, and do not become passive when you disagree.
Bring the CEO decisions, tradeoffs, material risks, and issues that genuinely require CEO judgment. Do not push routine coordination or operating choices upward.
Reduce the CEO's involvement in recurring follow-up, cross-functional coordination, and operational problem-solving.
Maintain transparent information flow between the CEO, leadership team, and organization; do not create unnecessary gatekeeping.