Head of Expansion
Fella Health
Head of Expansion
Fella Health
AIOS is building the world’s first full-stack AI doctor.
We’re at $450M ARR, growing from $7M/yr in April 2025. We’re faithfully serving >200k/mo patients via Bolt Pharmacy, our main UK brand. We’ve just launched Bolt Med, our international brand. We’re profitable.
Our strategy exists at the intersection of two strong theses:
The AI doctor that wins will get to escape velocity using GLP-1s, the fastest growing consumer product in history.
The $2T European healthcare market is overlooked by the most talented builders.
Our master plan:
Step 0 → $100M/yr by end of 2025: We went from $10M to $100M in 6 months serving the UK GLP-1 market.
Step 1 → $1B ARR by end of 2026: Since April 2025 we've grown from 3k to 200k UK active GLP-1 patients. We’ll continue this growth curve to hit $1B ARR.
Step 2 → $10B ARR by end of 2028: Blitzscale Europe. We’ll be Europe’s largest GLP-1 provider.
Step 3 → $100B/yr by end of 2030: Get regulatory approval across Europe for our Full Autonomous Prescribing (FAP) system. Win contracts at scale with European payers to mass replace human labor. We’ll be the dominant full-stack AI doctor in Europe.
Step 4 → $1T/yr by end of 2035: With one line of code and zero human time, you can use AIOS to treat any patient globally with any medication.
In so doing, we’ll become the world’s first trillion-dollar healthcare company.
We’re a young, founder-led company. This is still Day 1 and all our work is ahead of us.
You can read more about working with us here: Working at AIOS
We are building a world-class team.
As Head of Expansion at AIOS, your fundamental role is to rapidly increase the number of global GLP-1 customers that we can serve, starting with blitzscaling across Europe.
Your mandate is to get us launch-ready across every priority European market: all legal, clinical, pharmaceutical and v1 operational infrastructure firmly in place so our Growth team can test and scale new countries quickly.
You’ll swiftly identify which countries we should enter next based on market size, customer demand, regulatory complexity, and speed to launch.
You’ll also:
Close any critical legal, clinical, supply and operational gaps in European countries we can already serve.
Work out precisely what is preventing us from launching in each priority market we’re not yet live in
Carve out the fastest compliant route into each of those markets, whether that means building the required capabilities internally, partnering with established local providers, or acquiring existing infrastructure.
You will not be behind-the-scenes producing market-entry strategy decks. You’ll be hands-on driving every country launch, moving crisply between research, negotiation, diligence, and execution.
Great performance in this role means we can compliantly launch in any attractive European market in weeks rather than years, and we’re serving more than one million patients across Europe by the end of 2028.
If you nail the role, you’ll be a leading candidate for future senior Ops roles (VP, COO).
This is a full-time, mostly remote role with European travel as needed, and you’ll work async in the timezone of your choice — as long as you’re around until midday Pacific Time for calls as needed.
This is a senior role. You’ll report directly to me, Richie :) (CEO). I’m intense, so you’ll also be intense. You’ll work long days and regularly work weekends.
You’ll also work most closely with:
Joey Gracek (Head of Business Operations)
Jordan Pellikan (Chief of Staff)
Dave Lane (Head of Performance)
What are the key responsibilities of this role
Expansion: You’ll own European expansion from market research through launch readiness, turning “we should enter this country” into “we can compliantly serve patients here”, then repeat the process faster every time.
Prioritisation: You’ll determine which countries we should enter next based on market size, customer demand, unit economics, regulatory complexity and speed to launch.
Planning: You’ll identify precisely what is blocking us from launching in each priority country, then construct the plan to plow through blockers.
Build or Buy: You’ll choose the fastest compliant route into each market, whether that means architecting internally, partnering with established local providers, and/or acquiring existing infrastructure.
Legal & Regulatory: You’ll make sure we have the appropriate legal entities, local/national permissions, registrations, contracts and compliance frameworks required to operate.
Clinical: You’ll establish the clinical infrastructure required to serve patients, including helping staff the initial clinical team if building from 0.
Supply & Fulfilment: You’ll secure reliable medication supply, pharmacy partner(s), and fulfilment infrastructure so we can launch quickly and scale without operational constraints.
Readiness: You’ll coordinate the legal, clinical, product, operational and supply work required for our Growth team to begin testing each market as quickly as possible.
Playbook: You’ll turn what we learn from each launch into a repeatable system, reducing the time, cost and complexity required to enter the next country.
Experience: You have 5+ years in expansion, market launch, business operations, general management, or a similarly high-ownership role. I have a strong preference for people who understand & enjoy the scary speed of a high-growth startup.
Locale: You’re based in the UK or Europe, and you’ve launched and/or scaled businesses across multiple European countries, namely Germany, the Netherlands, France, Spain, Italy, and/or the Nordics.
Launches: You have personally owned taking European launches from idea to live operations. You know what it takes and remain close to the metal.
Judgement: You determine which markets are actually worth entering, what must be true for them to work, and whether we should build, partner, or acquire.
Execution: You smoothly move from strategy-mode into the trenches. You’re comfortable negotiating partnerships, reviewing contracts, setting up entities, solving supply constraints, and doing whatever else is required to compliantly launch.
Complexity: You can grok complex regulatory environments and work effectively across legal, clinical, and ops. You use experts to reach decisions where needed, while never outsourcing your ownership.
Clockspeed: You learn unfamiliar markets unusually quickly. You know how to find the right people, ask sharp questions, separate real blockers from perceived blockers, and reach high-quality decisions without months of research.
Project Management: You run several country launches concurrently without losing control of the details. You create clear plans with DRIs and deadlines.
Systems: You turn each launch into reusable scaffolding. You identify what can be standardised across Europe to continuously reduce the time required to launch.
Ownership: You truly operate like a founder. You don’t wait for complete information, perfect resources, or somebody else to remove a blocker. You take responsibility for the result until patients are being served.
Regulatory: You’ve operated in a heavily regulated industry and know how to move quickly without treating compliance as somebody else’s problem.
European Expansion: You’ve launched and scaled businesses across multiple European countries, namely Germany, the Netherlands, France, Spain, Italy, and/or the Nordics.
Evaluation: You have experience evaluating partnerships, joint ventures, licensing arrangements, or acquisitions as routes into new markets. You have conducted diligence, structured a deal, and closed it.
AI-Native: You use AI to research markets, analyse regulations, evaluate opportunities, draft plans, automate workflows, and increase the amount you can personally execute.
Talent: You’ve built and managed a lean, high-performance team across multiple countries. You detest incompetence in your team.
Founder: You’ve founded something (no matter how small), or joined a project early. You may want to start your own company in the future.
Figure It Out: You’re one of those timeless people who could be dropped anywhere in the world, in any century, and figure out how to make progress.
We aim to make this your life’s work. This should be the most challenging, most rewarding role of your life. Accordingly, these are the core cultural standards to which we hold ourselves & our team-members:
Belief in the mission: We will have served 100 million patients by the end of 2035 and we transform the life of most patients who join. We have a lot of work to do. We are obsessed with our patients and are dedicated to the mission.
Unwavering integrity: We are at the frontier, so we often live in ambiguity with no trodden path. When we can’t look to others for guidance, we must maintain impeccable ethics and unwavering integrity.
Only the paranoid survive: Bad sh*t is coming. By joining us, you’re choosing to sail straight towards the storms with unhesitating conviction. However much we’ve already done, however far we’ve already come — it’s still Day 1 and all our work is ahead of us.
If we’re average we fail: We are only interested in “insanely great”, a focus on the quality of our execution that in everyday life would be considered pathological. We have a dedication to excellence and reject incompetence.
Commitment to candor: That which can be destroyed by the truth should be. You get full transparency from the company and the company expects full transparency from you. We never say anything about someone that we wouldn’t say to them directly. We give feedback with love and do not need to protect people from fleeting physical sensations.
A maniacal sense of urgency: We execute at an intensity that most people think is impossible. Speed is critical and we need things done yesterday. We all work very hard and in such a competitive world there really is no other way to win.
Enduring frugality: We are frugal. We hate being wasteful and we are anti-luxury. A culture of cheapness keeps us young. We spend our cash wisely & carefully — in a way that would make our grandmas proud.
Bulldozing barriers: The world is malleable and we shape it. We truly believe this and act accordingly. We are relentlessly resourceful and are at the mercy of no-one but ourselves. You’ll be shocked how capable you are and how much you can achieve.
Keep your head down: We’re boring people doing exciting work. We don’t chase short-term status — we ignore short-term dopamine hits and focus on what matters. Outsiders will underestimate us and we revel in that.
The power of focus: We live in a world of power laws and we cannot overestimate the unimportance of practically everything. Know your One Thing, and nail it.
🎯 “You just build a f*ing amazing experience. Make each step amazing. Make every decision in the long term interest of the customer. Give the customer massively more value than you take.”
You get paid above market salary and you get early stage equity, so you get really rich if we nail this.
Compensation: $200k-$400k/yr + .15%-0.5% equity
The stuff below is cool as well.
Healthcare: comprehensive medical insurance (if appropriate).
Vacation: PTO with a yearly minimum (≥2wks/yr + local national holidays)
Personal development: budget for books, courses, coaching.
Personal wellness: budget for gym, health apps.
GLP-1s: free membership with a clinic offering GLP-1s.
Equipment: Macbook & work-from-home equipment provided as needed.
What are we missing? We're still early so you get to shape our culture.
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