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.