Chief Operating Officer

Chief Operating OfficerAbout the CompanyPhysician-partnered Site Management Organisation activating clinical research capability across 15 specialist practicesTypePrivately HeldAbout the RoleThe Head of Operations owns end-to-end build and management of the site network. In the near term that means being on the ground: visiting prospective partner practices, qualifying sites, standing up operations, hiring CRCs, and earning the trust of physicians who have never run a clinical trial. Over the medium term it means transitioning from builder to manager — running a multi-site operation with a high-performing team and professional operating infrastructure. Expect the first 3 months to be intensive and travel-heavy. Site activation requires physical presence and the kind of physician relationship-building that does not happen remotely. The role also requires complete fluency in our economic model: this person must be able to articulate the three-layer return to a research-naive specialist physician in plain language, and to understand the waterfall mechanics and NSCM-weighted distribution structure that underpin it. Core Responsibilities Business Development & Revenue Generation • Bring an active book of sponsor and CRO relationships capable of generating study placements from Day 1; this is a qualifying criterion, not a preference • Represent the company in sponsor and CRO conversations; negotiate study placements and Research Site Services Agreement terms • Maintain and grow the sponsor pipeline in alignment with the site network's specialty mix and enrollment capacity Site Activation & Physician Engagement • Travel to prospective and active partner sites to assess readiness, align on expectations, and build trust with research-naive physician leads • Translate protocol, regulatory, and GCP requirements into plain language for physicians and practice staff without prior research exposure • Design and deliver site-specific onboarding that integrates CRC and research operations into existing clinical workflows with minimal disruption to the practice's clinical revenue • Manage the State PI relationship during Years 1–2; coordinate the transition to local PI status from Year 3 as founding-practice physicians become GCP-qualified and protocol-experienced • Serve as the primary operational escalation point for active sites during the launch period CRC Hiring & Team Management • Own end-to-end CRC recruitment: sourcing, interviewing, offers, and onboarding into W-2 payroll structure • Assign, supervise, and develop CRCs across the site network in their non-clinical, administrative research coordination roles; maintain protocol compliance, data quality, and subject safety standards • Build a distributed, virtual-first team culture with clear accountability and professional development pathways • Manage CRC staffing proactively against the study pipeline; build the workforce plan ahead of site network growth Operations, Systems & AI-Enabled Infrastructure • Implement core operating systems: site activation workflows, CRC management protocols, sponsor reporting, CTMS configuration, regulatory tracking, and the eReg platform • Work fluently in a virtual and AI agent-enabled environment; proactively adopt tools that improve efficiency and enable the business to scale without proportional headcount growth • Own the KPI dashboard for site performance, study execution metrics, enrollment velocity, and site-level NSCM contribution • Manage the operational budget; understand the relationship between site-level EBITDA contribution and company-level distribution waterfall mechanics Cross-Functional & Governance • Reports into the CEO and Managing Director • Contribute to strategic planning including specialty expansion, additional state markets, and the platform's exit-readiness positioning What We're Looking For Essential • Demonstrable book of sponsor or CRO relationships with the ability to generate study revenue from Day 1; candidates without this will not be progressed • Significant clinical research operations experience, ideally within an SMO, CRO, or multi-site research network in specialist therapeutic areas • Direct experience managing CRCs or equivalent research site staff in a distributed setting • Proven ability to build credibility with research-naive specialist physicians — patience, clinical fluency, and persuasion skills in equal measure • Entrepreneurial operating style: comfortable with ambiguity, capable of building from scratch, energised by a moving target • Willingness and ability to travel extensively in the early phase (estimated 50–60% in months 1–3, primarily across NC, AZ, FL, IL, and TX • Genuine fluency in virtual collaboration tools and AI-assisted workflows; this is an operating norm, not an aspiration Strongly Preferred • Experience standing up new research sites or practice-based research networks from greenfield in cardiometabolic, CNS, or oncology • Familiarity with MCSA structures, Research Site Services Agreements, site budget negotiation, and sponsor contracting mechanics • Understanding of SMO financial mechanics including NSCM, site-level EBITDA contribution, and distribution waterfall structures • Prior experience in a startup or pre-institutional setting where the job description was a starting point, not a constraintFunctionsOperationsSkillsOperations Management requiredOperations Strategy required