Head of Expansion at AIOS — Remote, $200-$400k/yr + .15% - 0.5% equity

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)

Key Responsibilities

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.

Need to have

• 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.
• 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.

Nice to have

• 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.

Our cultural standards

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