Chief Operating Officer

• Provide executive leadership for clinical, medical, and operational functions
• Ensure services are clinically sound, operationally efficient, financially sustainable
• Oversight of service delivery, program operations, and quality outcomes
• Lead utilization management and behavioral health outcomes reporting
• Partner with CFO on clinical and operational performance
• Oversee designated Privacy Officer responsibilities

Chief Clinical and Operations Officer

• Own IO’s operational model, including the structures, systems, and rhythms that keep the organisation coherent across business units and geographies.
• Build the frameworks that enable functional autonomy while maintaining enterprise-wide alignment.
• Serve as the primary operational decision-maker for the company, with a clear view of what is happening, what is stuck, and what needs to change. This includes decision authority on facilities costs and M&A costs.
• Manage IO’s Book of Work, including what is in flight, what is next, what is blocked, and what needs to stop.
• Lead the Executive Committee, driving the operating cadence of the executive team, including agenda, decisions, and follow-through.
• Set the meeting philosophy for the executive team: meetings exist to answer why IO is not hitting its KPIs, and what remedy needs to be installed.
• Partner with the CEO to agree the internal communications strategy, including how change is explained and adopted across the company.
• Own the design and deployment of IO’s business operating system, including the frameworks, workflows, metrics, and governance structures that enable the organisation to run at scale without person-dependency.
• Partner with the Business Operating System Design team to ensure the operating model is built for adoption, and that it works for the people using it.
• Lead the transition from informal processes to systematic, AI-enabled infrastructure, replacing individual expertise with scalable, institutional knowledge.
• Ensure the operating system continuously adapts through feedback loops and AI-driven insights, so that the infrastructure improves itself over time.
• Identify the metrics that matter for the survival and success of the business, and build the operating system tuned to those metrics.
• Set the KPI framework across the organisation, including how KPIs are defined, cascaded, measured, and reviewed.
• Ensure decisions are grounded in measurement, and hold executive peers and function leaders accountable for the metrics in their domain.
• Drive continuous improvement through visible, quantitative signals rather than opinion or narrative.
• Support the CTO in the rebuild of IO’s engineering and delivery organisation, providing the operational scaffolding, governance, and enterprise services required.
• Partner with the CTO to help import the operating disciplines of elite software companies, including delivery discipline, product-engineering collaboration, and technical hiring standards, into IO’s wider operating model.
• Partner with the CTO and the Chief People Officer on technical headcount strategy and workforce planning, ensuring IO can attract and retain the calibre of engineers and product leaders the mission requires.
• Support the integration of engineering velocity and delivery metrics into IO’s performance management framework, so that delivery is measurable and improving.
• Drive the Enterprise Services model, ensuring People, ICT, Finance, and Legal operate as a coherent, SLA-driven internal service capability.
• Set service standards and performance expectations across enterprise functions, and hold function leaders accountable for delivery.
• Own contracts management, procurement, and vendor strategy at the enterprise level, including major supplier relationships and cross-functional contracts.
• Own enterprise facilities, workplace, and remote-first operations, including how IO supports a globally distributed workforce.
• Set IO’s strategy for how AI is used across the business, partnering with the VP of AI and Data to build AI-first workflows across operations.
• Own the workforce architecture model, including where AI agents operate, where humans direct, and how that balance evolves.
• Apply cybernetic principles, including feedback loops, requisite variety, and distributed control, to real operational problems, and design systems that self-regulate and improve.
• Champion IO as a demonstration case for what an AI-enabled organisation can achieve, including the practical build-out of agentic systems in support of operations.
• Work with the Chief People Officer (CPO) to ensure IO attracts, develops, and retains the talent it needs to execute its mission.
• Partner with the CEO and CPO on organisational design decisions, acting as the operational architect of the structure while the CEO sets strategic direction.
• Partner with the CPO to oversee compensation frameworks, performance management, and enterprise learning and development.
• Drive a culture of accountability, psychological safety, and continuous improvement, and set the standard through how the role operates.
• Champion leadership excellence across the functions in the COO’s remit.
• Hold group-level budget authority across the functions in the COO’s remit, ensuring resources are always allocated to strategic priorities.
• Partner with the CFO to deliver rigorous annual and quarterly budgeting, reliable reporting, and a clear view of IO’s financial health.
• Bring strong risk and cost sensing to major operational decisions, including a clear-eyed view of sunk costs, hidden dependencies, and what IO is signing up for when it commits.
• Ensure Legal and Compliance operate proactively, identifying risks before they become incidents.
• Own enterprise operational risk, business continuity, and incident response at the executive level.
• Partner with ICT and Legal on information security, data governance, and privacy at enterprise level.
• Own the operating model of IO’s Venture Studio, including how ventures are incubated, resourced, and moved through the studio pipeline.
• Ensure ventures have access to the enterprise services they need, and that shared infrastructure scales with the portfolio.
• Partner with the CTO, Chief Product Officer, and Chief Innovation Officer on the operational side of technical incubation and spin-outs.
• Act as the CEO’s operational peer, taking the weight of running the company so the CEO can operate at highest leverage on strategy, external relationships, research direction, and ecosystem leadership.
• Represent IO in high-stakes operational and governance contexts, including board reporting, regulatory conversations, and partner negotiations.
• Build and maintain strong relationships with IO’s functional leaders, board members, and key external partners.
• Tell the CEO what needs to be heard, with the honesty and directness that peer-level trust requires.
• Oversees organisation-wide and enterprise-level operational functions across IO, including Enterprise Operations, ICT, AI, People, Finance, Legal, and Venture Studio operations.
• Manages multiple VPs and divisional leaders across those functions.
• Influences the company’s overall direction and performance through broad functional leadership.
• Shapes and aligns organisation-wide strategic decisions alongside the CEO and President.
• Ensures that functional areas, including finance, operations, technology, and people, are aligned to support key growth and transformation goals.
• Operates with executive-level autonomy to set policies, allocate resources, and shape strategic initiatives across the operational domain.

• Building scalable operational systems and workflows
• Designing KPI dashboards and accountability rhythms
• Improving operational efficiency and profitability
• Identifying and eliminating bottlenecks
• Strengthening hiring, delegation, and organizational structure
• Translating strategic goals into weekly execution plans
• Coaching owners to lead with data instead of instinct
• Helping businesses become less owner-dependent and more scalable

Fractional COO – Turning Vision Into Daily Operating Reality

• Partner closely with the CEO and executive leadership team to drive company strategy, operational alignment, and scalable business execution.
• Lead company-wide operational cadence, including business reviews, performance management, cross-functional planning, and execution tracking.
• Build and optimize scalable processes, systems, and operational frameworks to support continued company growth.
• Align Sales, Marketing, Customer Success, Product, and Operations teams around shared company goals, revenue performance, and customer outcomes.
• Drive operational excellence across the customer lifecycle, including onboarding, adoption, retention, expansion, and overall customer experience.
• Partner with Finance on forecasting, budgeting, resource planning, and operational performance management.
• Establish and track key SaaS operational metrics, ensuring data-driven decision-making across the organization.
• Improve organizational efficiency, scalability, and cross-functional collaboration while driving accountability and execution consistency.
• Lead, mentor, and develop high-performing teams and managers while fostering a culture of transparency, ownership, and customer focus.
• Support CloudShare’s growth and organizational evolution by helping scale teams, operational structure, and internal processes.

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Chief Clinical and Operations Officer

Chief Operating Officer

Fractional COO – Turning Vision Into Daily Operating Reality

Chief Operating Officer – COO