Head of Operations

Terrarium

$120K — $180K *
Healthcare
Less than 5 years of experience
Job Overview by Ladders

Qualifications

  • 5-7 years of operational leadership experience within healthcare or regulated industries
  • Hands-on experience in clinical billing, including Medicare and Medicaid processes
  • Ability to manage multiple high-stakes projects simultaneously
  • Strong understanding of compliance frameworks relevant to healthcare
  • Proven problem-solving skills in fast-paced environments
  • Comfort with ambiguity and ability to thrive without rigid structure

Responsibilities

  • Drive special projects from inception to completion, supporting the CEO and board prep
  • Develop and implement compliant billing and revenue infrastructures
  • Manage daily operations of the revenue cycle, including claims submission and denial resolutions
  • Create a robust analytics and reporting framework to track performance metrics
  • Build and optimize operational processes to prevent issues before they arise

Benefits

  • Flexible work environment with a focus on results over process
  • Opportunity to shape operational strategy in a growing healthcare startup
  • High degree of ownership and influence over company direction
  • Collaborative culture that values initiative and problem-solving skills
  • Support for professional development and continuous learning opportunities
Full Job Description
About the role

As the Founding Head of Operations, you are the operating backbone of the company. You turn strategy into execution and you build the machine that lets a regulated healthcare company move fast without breaking. One day you are running a special project or prepping the board, the next you are standing up our billing rails or fixing a broken process before it scales.

You will own four things:
  • Force multiplier to the CEO: Run special projects end-to-end, drive hiring and onboarding, support fundraising and board prep, and own the dozens of cross-functional threads that keep the company moving.
  • Compliance and billing rails: Stand up the infrastructure that makes us legitimate and reimbursable. HIPAA, BAA, OIG review, SOC 2, entity and TIN, Medicare enrollment, consent and copay workflows, and audit-ready documentation.
  • Revenue cycle: Run the rails day to day. Time tracking, claims submission, acceptance, denials, and days to cash. Turn delivered navigation into clean, collected revenue.
  • Analytics and reporting: Build the reporting backbone. Track outcomes and leading indicators, run the weekly cadence, and give the team and the board a clear, honest picture of what is working.

Expect to make high-leverage operational decisions, move fast, and own outcomes end-to-end with minimal process. This is a true 0-1 role. You will define how the company runs.
Who we're looking for
  • You are a generalist operator who goes deep. You can run a fundraising workstream and a claims workflow in the same week and do both well.
  • You have hands-on clinical billing experience. You have personally run Medicare, Medicaid, or commercial billing, documentation, credentialing, and denials, and know what breaks and how to stay compliant.
  • High agency. You figure things out, move fast, and do whatever it takes to make progress. You don't wait for perfect requirements or perfect conditions.
  • You thrive in ambiguity and chaos. You prefer clear goals and maximum freedom over hand-holding and process.
  • You bring structure to messes. You see the broken process or the missing system before it becomes a fire, and you build the fix.
  • Low ego, high output. You want the intensity and ownership that only exists at the earliest stage of a company.

If you need constant direction, clear roadmaps, or a well-defined role, this is not the right place.

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