Director of Strategy and Operations

We’re looking for a highly driven Strategy & Operations leader to own the operating model behind Iterative Health’s most important growth levers. Today that means how quickly we activate clinical research sites onto trials and how many patients we randomize once those sites are active. This is a high-impact, high-visibility role for someone who thrives on operational complexity, designs systems that scale, and drives measurable improvement across a cross-functional organization.

You’ll diagnose where performance falls short of our targets, design the processes and systems that close the gap, and work across Site Operations, Regulatory, Legal, Commercial, Product, and Marketing to make our growth levers faster, more predictable, and more repeatable at scale. You’ll have clear outcome accountability for results such as our activation target and our randomization rate goals, and you’ll own the plans to reach them as the portfolio grows.

This is an ideal role for someone with a strategy and operations background who wants to own business-critical outcomes, build durable operational infrastructure, and work at the intersection of process design, cross-functional alignment, and performance management.

Where You'll Drive Impact

Performance Ownership

• Own our core growth levers and highest impact initiatives, including activations and patient randomizations: set targets, track progress, hold the functions involved accountable, and determine how we 2-3x activations
• Develop and maintain playbooks that can be operationalized across new trials, new sites, and new therapeutic areas
• Lead portfolio and site sequencing decisions that maximize revenue opportunity
• Monitor performance against targets, surface risks early, and lead the response before gaps compound

Process Design & Systems Thinking

• Diagnose where performance is falling short, from time lost across the activation lifecycle to conversion lost across the patient funnel, and identify the highest-leverage opportunities to improve
• Design and implement scalable, repeatable processes that reduce variability and make performance predictable across a growing portfolio of trials and sites
• Draw on a broad set of levers for each problem, including process design, org design, automation, incentives, and external partnerships
• Work with Product and Technology to build the systems and tooling that give leadership and operational teams real-time visibility into status, milestone risk, and portfolio sequencing

Cross-Functional Alignment & Stakeholder Management

• Define roles, responsibilities, and handoffs across the functions involved, ensuring clarity on who owns what and where accountability sits
• Partner with Site Operations, Regulatory, Legal, Commercial, Marketing, Medical Affairs, and Study Success to align on priorities and resolve cross-functional bottlenecks
• Design and run experiments and pilots to test new approaches before scaling them
• Develop creative approaches to vendor partnerships that accelerate activation timelines — thinking beyond traditional procurement toward relationships that are flexible, performance-oriented, and give IH a competitive advantage.

Team & Function Development

• Build and develop the team as the function scales.
• Establish the operating cadence, reporting structures, and accountability mechanisms that enable the team to perform consistently as volume grows.

What You Bring to the Team

• 7+ years in strategy and operations, management consulting, or a related function, with a track record of designing and implementing operational systems that improve efficiency and scale with a strong bias to action
• Demonstrated ability to diagnose process inefficiencies, design solutions, and drive cross-functional execution in a complex, multi-stakeholder environment
• Structured problem solving, with the ability to break an ambiguous problem into clear components before choosing a solution
• Strong systems thinking: you see how the pieces fit together and build processes that hold up as volume grows
• Experience defining roles, responsibilities, and operating models across functions, comfortable having the R&R conversation and driving alignment
• High ownership mindset, accountable for outcomes
• Excellent communication and stakeholder management skills, able to influence without authority across legal, regulatory, clinical, and commercial functions
• Comfortable operating in a fast-moving, ambiguous environment where the playbook is still being written
• Strong analytical instincts, able to use data to diagnose problems and measure the impact of process changes

Preferred Qualifications

• Experience in healthcare, clinical research, or a regulated industry where process design carries compliance implications.
• Experience building or managing small teams.
• Strong analytical instincts — able to use data to diagnose problems and measure the impact of process changes.
• Proficiency in Google Workspace and/or Microsoft Office tools (Excel, Word, Power

How We Work

• Collaborative and low-ego team environment
• High ownership and accountability culture
• Fast-paced and highly iterative growth environment
• Open communication and continuous learning mindset
• Mission-driven organization focused on improving patient outcomes
• Comfortable navigating evolving business priorities and opportunities

Benefits That Support You

We believe great teams do their best work when they feel supported — professionally and personally.

• Hybrid work environment with in-office collaboration two days per week in either our NYC, Boston or Southlake office
• Comprehensive medical, dental, and vision coverage, with up to 80% of premiums covered by Iterative Health
• Mental health and wellness support through Spring Health
• Health HSA or FSA options, and commuter FSA contributions supported by Iterative Health
• Unlimited PTO, 12 company holidays, and a company-wide shutdown between Christmas and New Years
• 401(k) program with a company match of up to 3% (up to $3,000 annually)
• Weekly in-office lunch benefit every Tuesday
• 100% company-paid short-term and long-term disability coverage
• Annual wellness and professional development stipend to support your health and growth
• And more!

New York pay range 160000 - 220000 USD