Chaos Architect (Founding Operations)

Artificer Health — Remote | Founding Team

Why this role exists

Every team like ours has a moment where it stops being a collection of smart people doing good work and starts becoming an actual company. That moment doesn't happen on its own. Someone makes it happen.

That person is not a title. They're not a function. They're the reason the engineer can focus on the integration instead of chasing down their onboarding paperwork. They're the reason the pilot contract got signed in three days instead of three weeks. They're the reason the founder's Monday morning starts with a clear picture of runway instead of a pile of things nobody touched.

Pepper Potts ran Stark Industries before Tony acknowledged it. Gwynne Shotwell built the operational spine of SpaceX while everyone else was focused on rockets. Mark Watney scienced the shit out of every problem on Mars with whatever he had in front of him. If any of those references made you sit up straighter — if you consider The Martian basically NSFW because of all the competence porn — keep reading. If you thought these were support roles, close this tab.

We're a pre-revenue healthcare startup automating prior authorizations — the single most friction-laden process in clinical care. Our team is eight people: a clinical reviewer who knows where the bodies are buried in utilization management, an AI wrangler who's appropriately paranoid about the difference between a model and a product, a semi-feral compliance dork who has seen too much healthcare theater to tolerate more, and five others who are deeply competent inside their lanes. None of them should be spending any part of their day thinking about payroll timing, vendor contracts, or whether the data room is organized. That's yours.

The role we're describing is not a back-office function. It's the operational substrate the rest of the company runs on. If the founder got sick for a week, nothing should break. That's the bar.

What you'll actually do

There is no clean list here, because the job doesn't have clean edges. But here's what's real:

Finance and runway. You own the books. Invoices go out, bills get paid, accounts get reconciled, and the runway number is never a surprise. You'll work with an outside accountant but you're not waiting on them for answers. Cap table management, budget tracking, and burn visibility are yours. When we raise, you build the financial model and organize the data room.

People operations. Offer letters, benefits administration, onboarding, multi-state employment compliance for a fully remote team. You will set this up from scratch. The Semi-Feral Compliance Dork will be in your orbit on employment policy and vendor risk — you'll work together, not around each other.

Legal coordination. We have outside counsel. You manage the relationship, own the queue, and make sure nothing sits. Pilot customer agreements, NDAs, vendor contracts — you're the first set of eyes before anything goes to legal and the person who closes the loop after.

Vendor management. You evaluate, negotiate, and manage every tool and service that isn't core product. You do not default to the enterprise tier. You ask whether we need it at all.

Operational infrastructure. HRIS, accounting software, document management, project management — you build these systems before the team realizes it needs them. If you've ever read a patio11 essay about how much operational complexity hides inside seemingly simple businesses, you already know what "running a healthcare startup" actually means under the hood. The intersection of HIPAA, multi-state employment law, payer relationships, and fundraising mechanics is not a back-office problem. It's an engineering problem with human variables. You find that interesting.

Office of the CEO. The thousand things that land on the founder's desk and shouldn't stay there. Scheduling, communications, board prep, investor updates, coordination across a team that is fully distributed and allergic to unnecessary meetings. You create clarity and remove friction, in that order.

What you bring

There's a version of this role that goes too junior and becomes an office manager when we need an operator. There's a version that goes too senior and wants to build a 12-person ops org when we need someone who'll also set up QuickBooks. You're neither.

You've been around the building. Maybe you were an early ops hire at a startup that scaled. Maybe you were a chief of staff who was actually doing it, not just scheduling it. Maybe you've run your own thing and learned that operations is the least glamorous and most load-bearing part of any business.

Concretely:

• You have set up financial operations for a small company — accounting software, payroll, cash management — not delegated it to someone else on day one.
• You have managed contracts and vendor relationships with real negotiating authority, not just collected signatures.
• You understand multi-state employment compliance well enough to know when to act and when to get a lawyer.
• You are comfortable with ambiguity in the form of "this hasn't been figured out yet," not "nobody told me what to do."
• You write clearly and directly. When you send a message, people know what you need and when. No paragraph-length preambles.
• You do not consider any task beneath you if it's blocking the team.
• You approach problems the way Watney approaches problems — figure out what you have, figure out what you need, build the bridge between those two things, and do not waste time wishing the situation were different.

Healthcare background helps. It is not required. What is required is the intellectual honesty to say "I don't know this yet" and the instinct to go learn it before it becomes a problem.

What we bring

Founding equity. The amount reflects that you're early and that this is a real stake, not a consolation prize.

A team that will not waste your time. Everyone here can describe their work in plain terms, ships things, and is direct about what isn't working. We have no tolerance for performance and no patience for bureaucracy we created ourselves.

The actual hard problem. Prior authorization is broken in ways that are specific, documented, and fixable — but fixing it requires building a company, not just a product. The operational complexity of what we're doing is real. If you want a role where you can make something out of nothing and see the whole board, this is it.

Fully remote with serious overlap with US business hours. Compensation is competitive for an early-stage company that is honest about being early-stage.

How to apply

Send an email to joinus@artificerhealth.com with "Chaos Architect" in the subject line.

Tell us about a specific operational problem you built a solution for from scratch. Not a system you inherited and improved. Something you stood up when nothing was there. What was the problem, what did you build, and what would you do differently.

We read every application. We respond to the ones that are direct.