Your Fractional COO for ABA.
Embedded operational leadership for founder-led ABA clinics — without the $250K salary. I run your operating cadence, install the systems, and coach your leadership team so growth stops feeling like chaos.
What a Fractional COO actually does.
Not advisory. Not a coach. An operating leader — measured on the same numbers you are.
KPI & performance visibility
Weekly operating dashboards so you stop feeling the business and start measuring it.
Staffing & hiring systems
Predictable BT/BCBA pipeline, structured onboarding, defined career paths.
Scheduling & utilization health
Fill rate, cancellation, authorization utilization — turned into weekly rhythms.
Profitability by service line
Margin visibility, labor optimization, comp structure that scales.
Leadership operating cadence
L10, scorecards, quarterly planning, accountability charts — installed and run.
SOPs & governance
The playbook a second location, a new director, or an audit can actually rely on.
First 90 days — and what happens after.
Days 1–30
Diagnose.
Full operational audit. Meet the team. Read the numbers. Identify the 3 highest-leverage moves.
Days 31–60
Install.
Stand up dashboards, weekly operating cadence, hiring pipeline, and the first two priority SOPs.
Days 61–90
Operate.
Run the cadence with your leadership team. Coach directors. Course-correct on live data.
Day 90+
Scale.
Deepen governance, expand automation, prepare for the next location or clinical line.
A fit if…
- $1.5M+ in annual revenue or 25+ staff
- Founder is still the operational bottleneck
- You have directors but no real operating rhythm
- You're planning a new location, service line, or acquisition
- You want a partner, not a slide deck
Not a fit if…
- Pre-revenue or first hires — you need a diagnostic first
- Looking for a full-time employee, not an embedded operator
- Not ready to make operational decisions in the next 30 days
Monthly retainer. Real accountability.
Fractional COO engagements are monthly retainers with a 90-day minimum. Scope, cadence and hours are calibrated to your stage during the diagnostic.
- Weekly leadership operating cadence
- Monthly KPI + financial review with the founder
- Direct director & manager coaching
- Hiring pipeline & interview leadership
- SOP + dashboard buildout ownership
- Async Slack/Teams access between sessions
Common questions.
How is this different from a consultant?+
A consultant delivers a report. A Fractional COO owns outcomes with you — leading the leadership team, running the cadence, and holding the org accountable to the plan.
How much time do you spend inside my clinic?+
Typical engagements run 30–60 hours/month across strategy sessions, leadership meetings, KPI reviews, hiring, and async support. Cadence is designed to your stage.
What's the minimum engagement?+
90 days to prove the model, then month-to-month. Most partnerships run 6–12 months as the operating system matures.
Do you work with multi-site groups?+
Yes. Multi-site is where operational infrastructure earns its keep — and where founder-dependent operations break first.
Will you replace my full-time COO eventually?+
The goal is either to graduate to a full-time internal COO (I help you hire and onboard them) or to stay long-term as the outsourced operating layer. Your call.
How do we start?+
Book a 30-minute strategy call. If there's fit, we run a 2-week paid diagnostic. If the diagnostic confirms it, we start the COO engagement the following month.
Let's see if fractional COO is the right move for your clinic.
30-minute working call. Operator to operator. Clear next step either way.
Book a Strategy Call