The offer is leadership, not a list
A fractional CIO or CTO is not an advisor who hands you a deck and leaves. It is a part-time executive who owns the technology agenda, sits in the leadership meetings, and is accountable for what gets done. I carry the responsibilities a full-time technology executive would, scaled to the time the company needs. The assessments, the roadmap, the security work, the org design are not separate products. They are the range of what owning your technology includes.
In regulated industries, healthcare especially, on both the payer and provider side, the stakes are different, and that is where I go deepest. Building and leading a high-performing engineering team is the same work whether you are in healthcare, financial services, mortgage, or software, and I have done it across all of them. That combination is why I can take either seat. Here is what that looks like.
The CIO seat
An established regulated company that needs a CIO
You run an established company in a regulated industry, and technology has to run the business without failing an audit or an operation. You need a CIO who has actually carried that weight, not someone learning your compliance environment on your time. This is where I go deepest. I have run technology in payer and provider organizations where security, uptime, and audit readiness were not abstractions, they were the business. At a multi-billion-dollar insurer I held systems above 99 percent uptime, and the security team under my direction ran the organization's NIST program. In a fractional CIO role this is exactly how it works, your security team does the assessment and remediation, and I provide the leadership and direction that gets it done. You get a CIO who already knows what your auditors, your board, and your operations expect.
Two roles, one person
A product company in a regulated market that needs both
You are building a product for a regulated market, which means two pressures at once. Your engineering organization has to move fast and actually ship. And what you build has to satisfy real compliance requirements, security, privacy, audit, that you cannot treat as an afterthought. Most companies your size solve this by hiring two executives, or by hiring one and leaving the other gap open. I close both. I came up as an engineer and architect, and I have built product inside regulated healthcare, so I can lead your engineering organization and make sure what it builds aligns to your industry's compliance needs, working alongside the people who own that compliance, not around them. The regulatory details differ between healthcare and banking, but the discipline of building product that holds up under that scrutiny is the same. In healthcare I ran a proprietary clinical platform under full HIPAA compliance across a multi-site healthcare operation, and took its uptime from 75 to 98.5 percent while stabilizing the team and the systems underneath it.
The CTO seat
A struggling engineering organization that needs a CTO
You already have a CIO running the business, but your engineering organization is not delivering, and you need someone who has actually built and led high-performing teams, not just managed them from a distance. I come in as the CTO alongside your existing leadership and own the engineering problem directly. This is the same craft in any industry, so it does not matter whether you are in healthcare or anywhere else. I took on-time delivery from 65 to 95 percent across a 300-person engineering organization by fixing how the work was planned, prioritized, and shipped. You get a builder who has turned around delivery before, working next to the leadership you already have.
How the engagement runs
Operating cadence
I work on a defined weekly commitment, not on call for everything. Most engagements run one to three days a week depending on what is in front of the company. We set the commitment against the actual work rather than a generic retainer.
Executive rhythm
I attend the leadership meeting and the board technology discussion. Between those, there is a standing weekly check with whoever owns delivery, and I am reachable for the decisions that cannot wait.
Decision rights
We agree up front on what I decide, what I recommend, and what stays with the CEO or board. A fractional leader without clear decision rights drifts into being generally helpful and accountable for nothing. Defining it at the start prevents that.
The first 90 days
The first engagement is structured so you can judge it on results, not on a promise.
Weeks 1 to 3
Assessment. Systems, vendors, security posture, technical debt, the engineering team, and what the board actually needs to see.
Weeks 4 to 6
A written plan. The priorities, the sequencing, what gets deprioritized, and the criteria for revisiting it.
Weeks 7 to 12
Execution on the top one or two priorities, with progress the leadership team can see.
By day 90 you have a clear technology picture, a plan tied to the business, and movement on the work that matters most.
When it ends
A fractional engagement is not meant to run forever. It ends when the company is ready for a full-time leader, or when the specific work it was brought in for is finished. If preparing for a permanent hire is part of the goal, I help define the role, the profile, and the first-year expectations, so the search is faster and the eventual hire is set up to succeed. The engagement builds toward its own replacement.
Who you would be working with
I have spent about thirty years in technology leadership, in CIO and CTO roles across health plans, provider organizations, and multi-country operations. I have run technology through acquisitions and integrations, stabilized failing platforms, built and managed engineering teams across several countries, and stood up data and AI work in regulated settings. I hold CHIME triple certification (CHCIO, CHISL, CHDHE).
I am builder and buyer. I have built technology organizations, and I have sat on the buyer side of technology diligence. That combination is what most companies need when there is no senior technology leader in the seat.
Start with a conversation
Send a short note about what is going on. We will set up a thirty-minute call where you get a direct read on your most pressing technology risk and an honest answer on whether a fractional engagement fits, with no obligation to continue.