Healthtech Scale-Up Operating System Architect — Care Network

The mandate

The network can open clinics quickly, but each new site reconstructs staffing, test routing, clinical escalation and local partnerships from founder knowledge. Patient turnaround, referral completion and contribution vary too widely to support the next four-country financing case. The defined problem is to convert one successful Kenyan core into a repeatable model without imposing processes that ignore regulation, language, clinical risk or demand shape.

The named deliverable is a Federated Healthtech Scale-Up Operating Constitution. It will contain the service-cell design, clinical decision boundaries, country-versus-platform accountabilities, site unit-economics model, minimum data contract, workforce ratios, launch gates, exception governance and replication playbook for connected diagnostics and primary-care partners.

Milestone one, due 30 October 2026, is a reconciled current-state baseline and failure-mode map; milestone two on 11 December is the approved operating-model design and country variance rules; milestone three on 12 February 2027 is evidence from two live replication pilots; milestone four on 26 March is the final constitution, investment sequence, training pack and transition of model ownership.

Acceptance requires the two pilots to sustain four consecutive weeks within signed thresholds for patient safety, result turnaround, referral closure, clinician utilisation, data completeness and site contribution. Finance must reproduce site economics within three percent, country leaders must identify exceptions without consultant interpretation, and the Chief Medical and Operating Officers must jointly approve every retained local variance before the Board Scale Committee accepts the final artefacts.

The client will provide de-identified patient-flow and laboratory data, site ledgers, staffing rosters, incident reviews, product telemetry, regulatory counsel and named clinical and operational leads in each country. A secure analysis environment and weekly sponsor decisions will be available, with data-access disputes resolved within three working days; fundraising materials, medical-device certification and direct management of clinics remain outside the statement of work.

Why this is external work

Country and product leaders are already delivering live care and cannot suspend expansion to design a neutral operating model. They also disagree over whether current variation reflects necessary localisation or weak operating discipline. An independent specialist can test both claims through pilots and leave a finite system rather than adding another permanent coordination layer.

What you will own

• Trace patient, sample, result, referral, cash and data journeys across representative sites, reconciling reported performance to observable handoffs and local ledger evidence.
• Define the service-cell architecture and minimum safe staffing for diagnostics, virtual review, escalation and partner-clinic workflows under different demand patterns.
• Specify which clinical, pricing, hiring, vendor and product decisions belong to the platform, country or site, with exception routes for regulatory or safety events.
• Build the site-economics model linking acquisition, clinician utilisation, test mix, laboratory routing, wastage, collection and referral completion to contribution.
• Run two replication pilots with explicit entry gates, weekly counterfactuals, deviation logs and stop conditions rather than treating opening day as proof of scalability.
• Codify country-variance tests that separate regulatory necessity, patient-access design and local economics from preference, legacy habit or founder intervention.
• Deliver the operating constitution, rollout sequence, controlled calculators, training cases and acceptance record into named client ownership.

Candidate qualifications

• Designed or materially rebuilt a multi-site operating model for digital health, diagnostics, ambulatory care or another clinically governed service network.
• Can evidence a replication decision where a site’s apparent growth concealed unsafe flow, incomplete referrals or structurally weak unit economics.
• Worked across at least two African healthcare markets and translated regulatory or care-pathway differences into explicit operating variants.
• Built clinic or service-cell economics from patient events and capacity behaviour, not only top-down revenue forecasts.
• Led live pilots with clinical stop criteria, protected patient information and sponsor-visible exception records.
• Transferred a scale playbook to country operators who subsequently opened or converted sites without continued consultant direction.

Non-negotiables

• Can mobilise remotely in October 2026 and attend monthly Nairobi sessions plus all scheduled East African pilot visits.
• Has no undisclosed investment, board seat or commercial interest in a reviewed laboratory, clinic chain, healthtech platform or proposed vendor.
• Will work inside the client’s secure environment and will not remove identifiable patient data or reuse proprietary clinical evidence.
• Accepts that the equity instrument is conditional, illiquid, dilutable and separate from the fixed cash project fee.

1. 49 words maximum. How would you distinguish justified country variation from operating inconsistency during the first baseline?
2. 49 words maximum. Describe one live healthcare replication pilot you stopped or redesigned, including the safety or economics evidence.
3. 49 words maximum. Which client roles and datasets must be available before you can sign a site-economics baseline?