Chief Operating Officer (COO)

N-21.ai; Northern (KY); Hybrid; USD 200,000 - 350,000; Full time

Benefits offered by this job

Equity / ESOPs

Job summary

N-21.ai is seeking a COO to act as the execution backbone, partnering with the CEO to design and scale a high-growth, AI-driven healthcare operations platform in the United States and India. The role emphasizes ownership, implementing scalable processes, and delivering measurable client outcomes.

The candidate brings 12–20+ years in healthcare, SaaS, or AI-led businesses, with a proven track record of scaling operations, managing global delivery, and driving ROI through operational excellence.

Qualifications

• 12–20+ years in Healthcare / SaaS / AI-led businesses
• Proven track record of scaling operations in high-growth environments
• Experience managing global delivery models (U.S. + India)
• Operator mindset: you build, execute, and scale—not just strategize

Responsibilities

• Build scalable operations across U.S. + India delivery
• Drive revenue and client outcomes
• Operationalize AI-led healthcare delivery
• Oversee risk adjustment operations (MA/ACA/Medicaid)
• Ensure CMS compliance & audit readiness
• Integrate AI + human workflows
• Own client expansion, retention, and delivery excellence
• Hire and scale high-performance teams
• Build board-level reporting & operational visibility

Job description

Global Operations (India Delivery Hub) Base + Bonus + Equity

As COO, you will be the execution backbone of the company, working closely with the CEO to:

• Build scalable operations
• Drive revenue and client outcomes
• Operationalize AI-led healthcare delivery

This is a 0 → 1 → scale role with direct impact on company trajectory. This is not a "maintenance COO" role. This is a build-and-scale mandate. We’re looking for a high-ownership operator who can translate vision into scalable, compliant, revenue-generating execution.

Company Overview:

We are building a category-defining Agentic AI platform transforming healthcare outcomes across Medicare Advantage and value-based care. Our mission is to deploy autonomous AI agents that directly improve clinical, financial, and operational performance for payers and providers.

Core Mandate:

• Design and scale U.S. + India delivery model
• Establish OKRs, dashboards, and execution cadence
• Build onboarding & implementation playbooks
• Oversee risk adjustment operations (MA/ACA/Medicaid)
• Ensure CMS compliance & audit readiness
• Integrate AI + human workflows
• Partner with Product & CTO
• Convert services into scalable, repeatable products
• Align roadmap with client outcomes & revenue goals
• Support enterprise deal execution
• Drive ROI- led value propositions
• Own client expansion, retention, and delivery excellence
• Hire and scale high-performance teams
• Optimize cost, quality, and turnaround time
• Oversee clinical, claims & EMR data pipelines
• Drive adoption of AI in operations with measurable impact
• Improve unit economics & gross margins
• Build board-level reporting & operational visibility

Key Responsibilities:

• Build & Scale Operations
• Revenue & GTM Execution
• Build India Delivery Engine
• Data, AI & Operational Excellence

What We're Looking For:

• 12–20+ years in Healthcare / SaaS / AI-led businesses
• Proven track record of scaling operations in high-growth environments
• Strong understanding of risk adjustment (preferred but valuable)
• Experience managing global delivery models (U.S. + India)
• Operator mindset: you build, execute, and scale—not just strategize

Compensation & Equity:

Competitive Base + Performance Bonus Meaningful Equity / ESOPs Opportunity to create outsized impact in a high-growth AI startup