Interim Chief Operating Officer — Controls (Healthcare)

The judgement calls in end-to-end accountability

In a healthcare services operation, the outcome a patient or a referring clinician experiences passes through many hands: a laboratory, a logistics provider, a sterile services supplier, an outpatient site, an IT vendor. When something goes wrong, each can show that its own piece met its own contract. The Interim Chief Operating Officer's work, reporting to the Country Managing Director with executive authority for 24 months, is to make somebody answerable for the outcome rather than the piece.

That raises hard calls. When a service failure sits between a supplier and a site, who holds it? When a site wants an exception to a common standard, is the reason clinical or historical? When an automation or outsourcing case promises savings, has anyone said who will adopt it, what it depends on, and what happens to patients if it falters? You will settle these as an executive, not as an adviser. You decide how operational calls are made and where a site head's own authority ends, define the proof a request for money, capacity or a control change must offer, and give each inherited commitment its verdict: keep, hold or close. You halt plans that would let exposure slip away from the person who should hold it, turn down investment cases with gaps, sign off the leadership team and the path concerns take upward, and settle disputes between the Country Managing Director and site heads before money is spent.

Twenty-four months of accountability made visible

Ninety days in, there should be an agreed map of supplier and site accountability, with one owner for each end-to-end service outcome and a written statement of how much each local head may decide. Around month nine the operating controls over suppliers and sites should have been tested with the Audit Committee Chair, and every gap found should have someone assigned to close it. By month 24 end-to-end outcomes should be reported by the supplier and site owners accountable for them, and the arrangements for raising problems should have been proven under genuine operational pressure, not merely drawn on a chart.

A record built in joint ventures

Through a joint venture you reset who decided, how money was released and how often performance was reviewed, and you have also led through succession and geographic expansion. Revenue of $330 million or more, at least 2,300 people and operations in seven or more countries describe the scale you have answered for. Your judgement was proven in clinical and service operations that had to keep running while decision rights moved between people. The seat requires operating cadence at level 4, and operating model, network footprint and quality and safety at level 3.

You know your first visible success may be something you ended rather than something you launched, and you can back it with evidence. You are able to describe an unresolved gap to a country managing director without using uncertainty to buy time. If ending an operations commitment would, for you, require every country head to agree, or if you want influence without owning 24 months of outcomes, this seat is not for you.

Meeting the people you would serve

The Country Managing Director will see you first, over video and in confidence, during week one. The Audit Committee Chair has the third week, who wants to work through how you would test controls over suppliers and sites. In week five you meet executives who lead the different functions, face to face, and in week seven you meet the whole board. Our assessment of each stage reaches you in writing within three working days.