Chief of Staff

Department: Operations

Location: US Remote, Canada Remote

Compensation: $150K – $200K • 0.1% – 0.4%

Employment Type: FullTime

About Finni Health

Finni Health helps BCBAs go independent. We provide the infrastructure for BCBAs to actually do it — credentialing, payer contracting, revenue cycle, HR, compliance, and the software that ties it together — so they can focus on delivering care to kids with autism instead of fighting insurance companies.

We support practices across a dozen+ states and are expanding into new ones every quarter. Were YC-backed, counted General Catalyst among our earliest investors, and are growing quickly in a market where families routinely wait months for services that should take days to start.

Were a small team moving fast in a heavily regulated industry. That combination is the job.

The role

This is a role for someone who wants to run things, not observe them.

Two things define it. First, you will own the companys metrics and operating rhythm — how we set goals, what we measure, how we review it, and whether anything actually gets closed out. Second, you will take real work off the CEOs plate permanently, not temporarily. Not help with — own.

Right now the founders are personally holding financing workstreams, multi-state legal and compliance buildout, payer strategy, vendor migrations, and org design at the same time. That is the constraint this role exists to remove. Over your first year, a meaningful share of that list becomes yours.

We expect this to become an operating role. The likely paths out of it are running payer strategy, running a new market, or owning a P&L. If you want a two-year credential, this isnt it. If you want to prove you can run a business, it is.

What youll actually do

• Own the metrics. Every number the board, our investors, and our team see runs through you: GTV, take rate, collection rate, clinician retention, time-to-first-session, credentialing throughput. You own the definitions, not just the dashboard — when a methodology changes, you decide how its restated and how its explained. Metric ambiguity at our stage is expensive, and closing it is your job.

• Own the operating rhythm. Goal-setting that actually cascades to teams. A weekly metrics review people prepare for. Exec meetings with decisions, owners, and dates. We run roughly fifteen concurrent strategic initiatives across a dozen-plus states — youll own the portfolio review that keeps them honest and kills the ones that should die. Our biggest internal risk is operating reactively. You are the counterweight.

• Take work off the CEOs plate. Board and investor materials, diligence workstreams, financing support, outside counsel coordination, key vendor relationships. Youll start by preparing these, then own them outright. The test isnt whether you produced a draft — its whether the CEO stopped thinking about it.

• Unblock the bottlenecks. Credentialing and payer enrollment gate how fast we grow, and the handoffs between credentialing, contracting, RCM, and clinical ops are where things go quiet. Youll instrument those seams, then fix them — occasionally by running a function yourself until it has a leader.

• Own the hard one-offs. New state entry analysis and launch. Multi-state corporate structure and regulatory compliance, working with outside counsel. Build-vs-buy calls and system migrations under time pressure. Standing up a function and hiring its first leader. These land with no playbook and a short fuse.

Your first 90 days

Concretely, heres what wed expect you to have taken over:

1. The metrics layer. One source of truth for company and team-level numbers, with documented definitions. You can answer any board question in under an hour.

2. The operating cadence. Quarterly goals set and cascaded, weekly metrics review running, exec meeting with real follow-through.

3. The initiative portfolio. Every live strategic initiative has an owner, a status, and a next decision date — and you run the review that surfaces the ones that are stalled.

4. One real workstream, end to end. Something currently on the CEOs plate that you own outright by day 90. Well pick it together based on what youre strongest at.

Who you are

• 4–8 years in a role that demanded rigor and speed: consulting, investment banking, PE/VC, or an operating role at a high-growth startup. Titles matter less than whether youve owned outcomes.

• You write exceptionally well. Clear, short, declarative. Youve built a deck or memo that changed someones mind.

• Youre genuinely strong analytically. You can build a model from a blank sheet, and you know when the model is lying to you.

• You operate with very little direction. When a project is 60% defined, you close the remaining 40% yourself and tell us what you assumed.

• Youre comfortable being the least expert person in the room and useful anyway — with clinicians, payer reps, healthcare lawyers, and engineers in the same week.

• Low ego about the work. Some weeks are board strategy. Some weeks are chasing a Medicaid enrollment packet through a state portal.

Bonus, not required

• Healthcare experience, especially multi-state provider operations, payer contracting, or Medicaid

• Experience at a marketplace, MSO, or other multi-sided business

• Youve been through a Series B or later fundraise from the inside

Why this job is good

Youll see every part of a healthcare company thats scaling, with direct access to the two people making the decisions. The work is unusually broad, the feedback is immediate, and the ceiling is an operating role youd otherwise wait years for.

Youll also work on something that matters. Families wait far too long for autism services, and the clinicians who could help them get buried in administrative work. Were fixing that.

Process

1. Intro call with the CEO (30 min)

2. Take-home exercise — a real problem were working on now (~2–3 hours, we pay for your time)

3. Working session on your exercise with both co-founders

4. Two conversations with team leads youd work with daily

5. References, offer

We move fast. Expect a decision within two weeks of your first call.

Finni Health is an equal opportunity employer. Were building a team as varied as the families we serve.