Open to senior operations & Chief of Staff roles

Nacim Iranmanesh.

I help digital health companies scale when growth breaks the operating system. Provider operations, executive cadence, revenue cycle. The structural work.

Hospital-trained operator. Startup-shaped tempo.

  • 11 years
  • hospitals → digital health
  • MPH
  • DHSc
  • CPPS
Irving, TX · remote
“Operationalizing systems to improve quality.”
Lorrie Evans, VP of Care Operations · managed Nacim at Brightline
Nacim Iranmanesh, healthcare operations leader and Chief of Staff, Irving TX
The practice

The practice.

Why I do this. And how I think about the work.

I grew up watching my parents do everything right and still get failed by American healthcare. Appointments scheduled wrong, paperwork no one walked them through, jargon that kept them out of their own care. They figured out what they could; I translated the rest. The operational layer where their version of that story plays out, every day, for thousands of other families, that’s what I’ve been working on ever since.

Eleven years in. Hospitals first: Boston Medical Center, Brigham and Women’s, Phoenix Children’s. I learned that compliance and patient safety are operational disciplines, not paperwork. Then digital health: Brightline, Manatee, Receptive. I learned how fast a small team can compound a problem when no one owns the system underneath it.

Fix the system, not the operator.

The work I get hired for is the structural kind, the kind that doesn’t ship in a sprint but shows up in next quarter’s denial rate. Process mapping the team commits to. SOPs that get re-read twelve times. Weekly AR working sessions held until denials stop hiding. Five-whys with people who already gave me three answers they thought I wanted. The work that actually changes outcomes is the durable kind, separating human error from system failure, getting to root cause, and undoing the invisible workarounds people built to survive a broken system.

First-generation American, fluent in Farsi. MPH from Boston University. DHSc from A.T. Still. CPPS since 2018.

Capabilities

What I run.

Domains I own.

Provider operations, end to end

Licensing, credentialing, intake, plus the revenue cycle that runs underneath, verification, denials, AR, vendor integration with Candid, Nirvana, Healthie.

Operating cadence + executive accountability

KPI dashboards, weekly working sessions, OKR reviews, board prep, the operating system underneath the strategy deck.

Cross-functional execution

Translating CEO priorities into shipped work across engineering, clinical, finance, and growth, without losing speed or detail.

Provider rigor in startup environments

CPPS + Just Culture + HRO discipline brought into venture-backed teams without slowing the business.

The structural work, beneath the roadmap.

Selected work

Selected work.

Diagnosis through delivery, end-to-end.

The system should stay after I leave.

Numbers available on request; the systems and outcomes shown here are cleared to share. Flip any case between its before and after state to see what changed.

01 Manatee, Inc. May 2023 to Dec 2025

Rebuilt revenue cycle from a team of one to an accountable operation, through a live EMR migration.

Director, Clinical Operations → Sr. Director of Operations  ·  Pediatric mental health practice

I took over RCM six months into my role, mid-migration from SimplePractice to Healthie, a platform that didn’t support end-to-end RCM out of the box. The work was to turn it into an operation that didn’t depend on one person being there.

  • single owner navigating growth → end-to-end RCM operation
  • manual claim correction → Candid rules engine, pre-API
  • manual VOB at billing → Nirvana real-time eligibility at booking
  • SimplePractice → Healthie live, with patch systems
  • no AR review cadence → weekly working session, named denial ownership
  • clinical operations only → ops + licensing + credentialing

OutcomeHeld denial rate under MGMA benchmark during the migration. Authored the Candid rules engine driving the majority of claims through pre-API auto-correction. Net collection performance materially improved.

Specific financial outcomes withheld per confidentiality. Happy to walk through in conversation.

02 Phoenix Children’s Hospital Feb 2021 to Sep 2024

Built the leadership data and safety infrastructure at Barrow Neurological Institute.

Clinical Quality Improvement Manager  ·  Barrow Neurological Institute

Leadership at Barrow needed a unified data view to scale a pediatric neuro institute responsibly, plus behavioral health capacity and zero-suicide escalation infrastructure.

  • no unified leadership view → leadership KPI dashboard
  • limited behavioral health capacity → billable psychiatry + LCSW
  • informal safety protocols → zero-suicide HRO with no-blame escalation
  • ad-hoc operating review → weekly review cadence behind the dashboard

Outcome3.5 years embedded with institute leadership. Dashboard, behavioral health workflows, and zero-suicide protocols remained embedded in the operating model after departure.

03 Receptive Health Dec 2025 to May 2026

Chief of Staff across three Receptive Health brands.

Chief of Staff to the CEO  ·  Three-brand consumer health portfolio

Three Receptive Health brands, TNC, ADHD Advisor, and Pettable, were scaling without a shared operating cadence or self-service support layer.

  • 3 brands, no shared cadence → cross-brand operating rhythm
  • manual follow-up scheduling → auto-booking in the intake flow
  • no self-service support → 2 Zendesk Help Centers + AI chatbot
  • no cross-brand provider comms → provider newsletter cadence

OutcomeShipped 4 operating systems across 3 brands during the first quarter of the role.

Selected examples are non-confidential summaries of operating work.

Testimonials

In their words.

From managers, peers, and cross-functional partners who’ve worked alongside me.

  1. “Nacim excels at building process, policy, and data insights, operationalizing systems to improve quality. I’d highly recommend her to build a quality department or team.”

    Lorrie Evans  ·  VP of Care Operations  ·  managed me directly at Brightline

  2. “Nacim brought strong operational acumen across billing and revenue cycle management, plus onboarding, licensing, and credentialing. She streamlined processes, anticipated needs, and supported providers with clarity and consistency.”

    Baaba Onyejiji, M.A., LMFT  ·  Director of Clinical at Manatee  ·  executive leadership team

  3. “As Chief of Staff, she quickly identified opportunities to improve workflows and helped implement automations that made day-to-day operations significantly more efficient. I’d gladly recommend her to any organization looking for a strong operational and strategic leader.”

    Nicole Robinson  ·  Clinical Recruiter at Receptive  ·  cross-functional partner

The same system, running without me.

Experience

Eleven years.

Started in hospitals. Moved into digital health. The work has been the same: build systems people don’t have to remember.

Hospital to startup — the same work underneath.

Hospital systems
Digital health

Boston Medical Center

Team Coordinator → Sr. Administrative Coordinator · Boston, MA

2015 – 2017

Brigham and Women’s Hospital

Clinical Pathways PM → Ambulatory Quality & Safety Manager → Program Manager · Boston, MA · 3 promotions

2017 – 2021

Phoenix Children’s · Barrow Neurological

Clinical Quality Improvement Manager · Phoenix, AZ

2021 – 2024

The move · 2022

Brightline, Inc.

Sr. Manager, Care Quality · pediatric telehealth · Remote

2022 – 2023

Manatee, Inc.

Director → Sr. Director of Operations · Remote

2023 – 2025

Receptive Health

Chief of Staff to the CEO · 3-brand portfolio · Remote

2025 – 2026

Also: Subject Matter Expert, Western Governors University MHA program (concurrent contract, 2024–present).

Writing

In writing.

Current pushes. Writing on patient safety, operations, and what the work actually looks like.

  1. Patient Safety Isn’t Seasonal: Five Tips Every Health System Should Follow

    Patient Safety & Quality Healthcare  ·  Mar 2026

  2. A Love Letter to Healthcare

    Swaay.Health  ·  Feb 2026

Patient safety isn’t seasonal.

Principles

How I work.

Four principles. Earned, not borrowed.

Systems that outlast the people who built them.

  1. 01

    Build teams that can operate without me.

    I document workflows, teach the operating logic, and remove single points of failure. The playbook should stay with the team, not live in one person’s head.

  2. 02

    Build systems people don’t have to remember.

    Asking someone to hold a complicated process in their head, day after day, is setting them up to fail. I automate the manual work so the system carries what doesn’t require judgment.

  3. 03

    Create conditions for early signal.

    People surface problems earlier when they trust the system will respond fairly. I build that psychological safety first, because dashboards only matter if the team tells the truth before the metric turns red.

  4. 04

    Get to the root cause.

    I ask why five times. The first answer is the symptom; the real cause is a broken handoff, a missing incentive, unclear ownership, or a system rule that’s no longer working.

Toolkit

What I work with.

Systems, capabilities, and frameworks I lean on. Patient safety is the operating discipline beneath them.

Healthcare Platforms

PL-01
  • 01·AHealthieCore
  • 01·BCandid
  • 01·CNirvana
  • 01·DSohar Health
  • 01·EAvaility
  • 01·FEpic
  • 01·GeClinicalWorks
  • 01·HSimplePractice

Operations Tools

OP-02
  • 02·ATableauCore
  • 02·BZapier
  • 02·CZendesk
  • 02·DAsana
  • 02·EJira
  • 02·FSmartsheet
  • 02·GGSuite

Capabilities

CP-03
  • 03·AProvider OperationsCore
  • 03·BService Delivery
  • 03·CCredentialing
  • 03·DRevenue Cycle Management
  • 03·EPayer Operations
  • 03·FVOB
  • 03·GDenials
  • 03·HEligibility

Frameworks

FR-04
  • 04·AJust CultureCore
  • 04·BHRO
  • 04·CNAHQ 8-Domain
  • 04·DHIPAA / HITECH
  • 04·EValue-Based Care
  • 04·FSix Sigma

AI · Intelligence Layer

AI-05
  • 05·AClaudeCore
  • 05·BChatGPT
  • 05·CGemini
  • 05·DCopilot

Core = deepest tools, in daily use

AI is built into how I operate, not bolted on top. I work across Claude, ChatGPT, Gemini, and Copilot every day — building automations, workflows, and dashboards, running research, and reviewing policy drafts before they reach legal. Less busywork, better decisions, faster.

Patient safety is the discipline beneath every tool.

Education

What’s earned.

Four credentials. Each one still pulls weight in the work.

No credential here is decorative.

Doctor of Health Sciences

A.T. Still University · Leadership & Organizational Behavior

How systems shape behavior. The discipline behind redesigning the system instead of blaming the operator.

Master of Public Health

Boston University · Health Policy & Management

Why the system fails the way it fails, and where policy decisions land on the operational floor.

B.S. Biology

University of Arizona · Minors in Chemistry & Persian Studies

Clinical literacy to read the chart. Cultural fluency to translate it for the family in the room.

Certified Professional in Patient Safety

Earned 2018 · current through July 2027

Just Culture, HRO, root-cause discipline. The operating spine under everything else I run.

Contact

Let’s talk.

Pick the door that fits.

The best roles I’ve found started with a real conversation. Tell me the operations problem you’re sizing up, and I’ll help uncover the one underneath.

Hiring for a senior operations or Chief of Staff role

For teams scaling beyond what their current systems can support. Send me the problem—and the job spec, if there is one.

Book a call →

Exploring fractional or advisory help

For founders who need senior operational support before they’re ready for a full-time hire.

Anything else

Ideas, introductions, or comparing notes on scaling messy systems. Start with my most-read posts, then connect with me on LinkedIn.

See my posts →

Symptoms are easy. I go after causes.

Irving, TX · Remote and travel friendly View my résumé Save my contact
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