Chief of Staff

Fathom; Oxenthwaite; On-site; GBP 90,000 - 140,000; Full time

Job summary

Fathom, the leading autonomous medical coding platform, is seeking a Chief of Staff to work directly with the CEO. You will own the systems that keep the company running and drive cadence for board and investor communications, while leading the deployment of AI agents across our operations.

This operator-level role sits close to major decisions, scaling processes and building AI-enabled workflows using Claude, HubSpot, and internal data.

Qualifications

• 4–8 years in bizops or strategy roles at a growth-stage company
• Experience building workflows with LLMs and agents, with light scripting, APIs, and CRM configuration
• Strong analytical chops; ability to model data in Excel and tell a clear narrative
• Excellent writer; able to draft board memos or investor updates
• Systems thinker with bias for action
• High judgement and discretion with sensitive information
• Healthcare or enterprise SaaS experience is a plus; curiosity about revenue cycle and clinical AI

Responsibilities

• Run the leadership team’s operating cadence: staff meetings, OKRs, quarterly planning, and follow-through
• Own the operational backbone across GTM, finance, and people: pipeline reviews, forecasting, reporting, and planning cycles
• Own HubSpot and our core internal tooling as systems: data quality, stage definitions, and dashboards for leadership and the board
• Take on special projects the CEO would otherwise own: diligence and RFP responses to market analyses and internal process design
• Identify what’s breaking as we scale and fix it before it becomes a fire
• Map internal workflows and identify where AI agents can take over work: pipeline hygiene, reporting, prospect research, RFP drafting, onboarding, investor updates
• Build and deploy those agents using tools like Claude, HubSpot, and our internal data, and own them in production
• Establish the standards for how the company uses agents: what gets automated, how outputs are reviewed, how we measure hours and dollars recovered
• Be the internal evangelist and teacher; get every function running on agents
• Own the board meeting cadence end to end: agenda, materials, pre-reads, follow-ups
• Draft and refine investor updates, board decks, and ad hoc communications with the CEO
• Track commitments made to the board and investors through to completion

Skills

AI tools

LLM workflows

Scripting basics

CRM configuration

Analytical thinking

Written communication

Systems thinking

Tools

HubSpot

Claude

Job description

About Fathom

Fathom is the leading autonomous medical coding platform, ranked #1 by KLAS in its category. Our AI codes clinical encounters end to end for health systems, physician groups, payers, and revenue cycle partners, including Stanford, UC Health, UNC Health, and AdventHealth. We’re backed by Lightspeed, Founders Fund, and CVS Health.

The role

We’re hiring a Chief of Staff to work directly with the CEO and extend the leadership team’s reach. This is an operator’s job: you’ll own the systems that keep the company running, drive the cadence of board and investor communications, and lead how we deploy AI agents across our own operations. We build autonomous AI for our customers; we expect to run the company the same way. You’ll sit close to every major decision and be expected to move them forward.

What you’ll do

Operations support

• Run the leadership team’s operating cadence: staff meetings, OKRs, quarterly planning, and the follow-through that makes them stick
• Own the operational backbone across GTM, finance, and people: pipeline reviews, forecasting, reporting, and planning cycles
• Own HubSpot and our core internal tooling as systems: data quality, stage definitions, and the dashboards leadership and the board rely on
• Take on special projects the CEO would otherwise own, from diligence and RFP responses to market analyses and internal process design
• Identify what’s breaking as we scale and fix it before it becomes a fire

Agentic implementation

• Map our internal workflows and identify where AI agents can take over work outright: pipeline hygiene, reporting, prospect research, RFP drafting, customer onboarding, investor updates, and more
• Build and deploy those agents yourself using tools like Claude, HubSpot, and our internal data, and own them in production
• Establish the standards for how the company uses agents: what gets automated, how outputs are reviewed, how we measure the hours and dollars recovered
• Be the internal evangelist and teacher; get every function running on agents, not just the ones you touch directly

Board and investor communications

• Own the board meeting cadence end to end: agenda, materials, pre-reads, and follow-ups
• Draft and refine investor updates, board decks, and ad hoc communications with the CEO
• Track commitments made to the board and investors through to completion

What we’re looking for

• 4–8 years in a role that rewarded both rigor and execution: bizops or strategy at a growth-stage company, consulting, banking, or a prior chief of staff seat
• Hands-on with AI tools. You’ve built real workflows with LLMs and agents, not just used a chatbot, and you’re comfortable with light scripting, APIs, and CRM configuration
• Strong analytical chops. Comfortable building a model in Excel, pulling your own data, and turning it into a clear narrative
• Excellent writer. You can draft a board memo or investor update the CEO would send with light edits
• Systems thinker with a bias for action: you’d rather build the process than describe the problem
• High judgment and discretion with sensitive company, customer, and investor information
• Healthcare or enterprise SaaS experience is a plus; curiosity about revenue cycle and clinical AI is required

Why this role

You’ll get an unusually direct view into how a category-leading healthcare AI company is run and grown, and a mandate to rebuild its operations around AI agents. People who succeed here typically go on to lead operations, a business unit, or found their own company.