Chief of Staff

Fathom; California; On-site; USD 140,000 - 190,000; Full time

Job summary

Fathom seeks a Chief of Staff to directly support the CEO and extend the leadership team’s reach. This operator role will own core systems, drive board and investor communications, and lead deployment of AI agents across the company.

You’ll sit close to major decisions and move them forward with disciplined execution. You’ll build and scale internal workflows, own critical tools like HubSpot, and guide projects from diligence through market analysis and process design.

Qualifications

• 4–8 years in a role that rewarded rigor and execution at growth-stage firms
• Hands-on with AI tools; built real workflows with LLMs and agents
• Strong analytical chops; able to model data and tell a story
• Excellent writing; able to draft board memos or investor updates

Responsibilities

• Run leadership team cadence: staff meetings, OKRs, quarterly planning and follow-through
• Own operational backbone across GTM, finance, and people: pipeline reviews, forecasting, reporting
• Manage internal systems (HubSpot, dashboards) and ensure data quality
• Lead special projects from diligence to market analyses and process design
• Identify and fix scaling bottlenecks before they become fires
• Map workflows to identify where AI agents can automate; deploy and oversee production agents
• Set internal standards for automation, review outputs, and measure impact
• Own board/investor communications: agenda, materials, pre-reads, follow-ups

Skills

BizOps

Strategy

AI workflows

Executive communication

Data analysis

Systems thinking

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.