Fractional Head of Operations (COO-level)

ABOUT KINSTEAD
Kinstead Health makes it possible for experienced nurse practitioners to own independent, insurance-based practices. NPs own their practice; we run everything that usually stops them: entity formation, credentialing and payer contracts, billing and revenue cycle, the EHR, phones, scheduling and patient acquisition. Our promise to NPs: start your practice in 60 days, get paid on a guaranteed per-visit rate, and keep your clinical independence.
- 50+ nurse practitioners across Massachusetts, Maryland and Connecticut, expanding along the East Coast
- New practices launching every week, with strong inbound demand from NPs
- Monthly patient visits up 3x in a single quarter (June to September 2026)
- Our own technology platform: every practice is moving onto Kinstead-built EHR and billing infrastructure
THE OPPORTUNITY
Kinstead has found fit with NPs; the next chapter is scale. We're launching practices every week, adding payers and states, and launching new products for practice owners regularly. We want a seasoned operator to design how Kinstead runs at 200+ practices, and to build it now, while the foundation is being set up.
Kinstead has found fit with NPs; the next chapter is scale. We're launching practices every week, adding payers and states, and moving the network onto our own practice management + EHR platform. We want a seasoned operator to design how Kinstead runs at 200+ practices, and to build it now, while the foundation is being set up.
- Design the operating model for a multi-state provider network: launch, credentialing, revenue cycle and provider support
- Turn proprietary platform data into the KPIs that run the company and anchor our board reporting
- Shape what we automate next, alongside an engineering team that ships every week
- Lead a lean, distributed operations team and a bench of specialist partners
This is a leadership seat with real decision rights, scoped for a fractional schedule.
WHAT YOU'LL OWN
You own how operations runs end to end: the cadence, the metrics, the processes, and the partners. You set the system; your team and partners execute inside it.
KEY RESPONSIBILITIES
Operating Cadence & Reporting
- Own the weekly operating review, KPI definitions, and the scorecard used by founders, board members, and investors.
- Outcome: One trusted set of numbers behind every weekly decision.
Revenue Cycle
- Oversee revenue cycle performance across billing partners and our RCM platform, including claim throughput, denials, accounts receivable (A/R), and collections.
- Outcome: Best-in-class collections and cash velocity as volume scales.
Credentialing & Payer Enrollment
- Manage the credentialing pipeline, payer status, enrollment records, and expiration dates across every state we serve.
- Outcome: Faster time to in-network status with every new state and payer.
Practice Launch Engine
- Own the contract-to-first-patient playbook, including its gates and service-level agreements (SLAs).
- Outcome: Industry-leading launch speed, measured and improving every month.
Provider & Patient Operations
- Own the support model for nurse practitioners (NPs) and the front desk, including routing, SLAs, and quality standards.
- Outcome: A provider experience NPs recommend to their colleagues.
Partners
- Own SLAs, scorecards, and commercial terms for our specialist partners.
- Outcome: Every partner measured, accountable, and scaling with us.
People & Systems
- Lead the operations team, manage the SOP library, and establish automation priorities with engineering.
- Outcome: An operation that scales ahead of growth.
WHO YOU ARE
You've built and scaled operations at a healthcare services company, and you can lead at that level in 15 focused hours a week.
Must have
- 15+ years in operations, with 5+ in a senior role (COO, VP Operations, Head of Operations) at a healthcare services company: MSO, physician or NP group, multi-site practice, or tech-enabled provider
- Deep command of the revenue cycle: claims, denials, A/R, payer enrollment and credentialing. You know what best-in-class looks like and how to get there
- A record of scaling a repeatable, multi-location launch or onboarding process
- Experience leading distributed teams and specialist partners through clear SLAs and scorecards
- You build the reporting yourself: you define the metrics, find the data and make it a weekly habit
- Systems thinking with a bias to action. You write the SOP, then delegate it, then automate it with engineering
- You thrive at a fast-growing company: you move quickly, decide with judgment and build what doesn't exist yet
Strong plus
- Fractional or interim COO experience with high-growth startups
- PC-MSO structure and multi-state healthcare compliance, including HIPAA
- Medicaid managed care and Medicare enrollment experience in the Northeast or Mid-Atlantic
- Has led an EHR or RCM platform rollout
- Has worked alongside an engineering team to turn operational workflows into product
HOW WE'LL WORK TOGETHER
You'll run operations as a leader with real authority, on a cadence built for 15 hours a week.
- Weekly: you run the ops review with the founders and own its scorecard; you hold the standing calls with our billing and credentialing partners
- Monthly: you deliver an operations report covering launches, credentialing, revenue cycle and provider productivity, with a short list of decisions you need from us
- Async by default: Slack, Notion and our internal tools; you decide what needs a meeting
- Decision rights: you set process, priorities and SLAs for operations and the people and partners who execute them
What this role is not
- Not an executor. Your operations team and partners own the day-to-day work; you design the system they work in and hold it to a standard.
- Not engineering. Our engineering team owns the platform and integrations. You own the requirements, the data definitions and the priority of what to automate.
- Not clinical. Our medical and clinical director owns clinical and compliance oversight; you make sure the operations around it run cleanly.

Employment type
FullTime

Work arrangement
Yes