Fractional COO
Operational Leadership Without a Full-Time Hire
For practices that need someone running the operational side of the house on a retained basis. Weekly cadence, clear accountability, and a 90-day minimum so the work has time to show up in the metrics.
What we own
A fractional COO provides experienced operational leadership, structure, and accountability without requiring a full-time executive hire. The fractional COO is accountable for driving the work, maintaining the operating cadence, surfacing barriers, and keeping agreed priorities moving.
Weekly Operating Cadence
A standing weekly session with you and your leadership team: metrics, blockers, decisions, and owners. Nothing sits for a month.
Revenue Cycle Oversight
Denials, A/R aging, authorization backlog, and collections are reviewed on a fixed rhythm with accountable owners and escalation paths.
Staffing and Capacity
Templates, coverage models, overtime patterns, and hiring sequence, managed against the schedule and the budget rather than by instinct.
Vendor and Contract Management
Renewal calendars, negotiations, and consolidation opportunities handled before auto-renewal removes the option.
Leadership Development
Your practice manager or administrator is coached on the operating system, so capability stays in the building when the engagement ends.
Board-Ready Reporting
A monthly operating package your partners can read in ten minutes: what moved, what did not, and what happens next.
Authority and scope
Edison Breakwater can lead operational initiatives and coordinate execution with practice leadership and staff. Decision authority remains with the client except where specific authority is expressly delegated in writing. The fractional COO does not sign contracts, commit funds, hire or terminate staff, change compensation or clinical protocols, determine medical necessity or coding, submit claims, enter payer agreements, access bank accounts, or act as a corporate officer.
The objective is for operational improvements to create measurable value that exceeds the cost of the engagement. The opportunity and timing vary substantially by practice.
Who it fits
Practice profile
- • $5M to $50M+ annual revenue
- • 5 to 200+ clinical FTEs
- • Single or multi-site
Situation
- • No dedicated operational leader
- • Growth outpacing infrastructure
- • Leadership stretched across clinical and admin
Commitment
- • Weekly cadence
- • 90-day minimum
- • Willingness to measure and decide