Director of Office of the CEO, Founder in Residence

Join a team of brilliant, passionate innovators determined to transform healthcare. At BillionToOne, we've built a category-defining, publicly traded company on Nasdaq where transparency fuels trust, collaboration drives breakthroughs, and every contribution moves the needle on our mission to make life-changing diagnostics accessible to all. We don't just aim for incremental improvements; we build products that are 10x better than anything that exists today.

Our scientists, engineers, sales executives, and visionaries are united by an unwavering commitment to changing the standard of care in prenatal and cancer diagnostics. This is where cutting-edge science meets human compassion, and every innovation you contribute helps remove the fear of the unknown from some of life's most critical medical moments.

If you're driven by purpose, energized by innovation, and ready to help shape the future of precision medicine at scale, this is where you belong.

We are seeking exceptional entrepreneurial builders to join BillionToOne's newly launched Founder in Residence Program as a Director, Office of the CEO. In this 12 to 18 month program, you will work directly with the CEO and Chief of Staff on the company's highest-priority strategic and operational projects, and graduate into a permanent senior operating role at the Director or Senior Director level.

This is one of the highest-leverage roles at BillionToOne. You will be deployed onto a portfolio of high-impact projects each quarter — from new product launches, to commercial strategy, to operational turnarounds, to incubating new business lines and capabilities. Your portfolio of 1-2 projects will be revisited each quarter so you are always working on what matters most to the company.

The ideal candidate is a first-principles thinker, a builder, AI-native, and exceptionally sharp. You have founded a company, operated at the most senior level of a top scaleup, or built a track record of high-impact strategic work, and you are looking for your next high-leverage seat — one that gives you scale, mission, and direct CEO exposure without starting from scratch.

This role is a hybrid (onsite 3 days/week) position and reports directly to the VP of Business Operations and Chief of Staff, with active co-sponsorship from the CEO.

• →Own CEO-Priority Projects: Lead one or more of BillionToOne's highest-priority strategic and operational initiatives each quarter, sourced directly from the CEO and Office of the CEO. Project types span new product launch support, commercial and go-to-market strategy, business development, operational excellence, competitive response, and the incubation of new business lines.
• →Find Broken Things and Fix Them: Identify under-performing processes, workflows, or functions. Diagnose root cause, design the fix, and drive execution end-to-end with cross-functional teams.
• →Cross-Functional Leadership: Lead and influence cross-functional teams across Sales, Product, Lab Operations, Compliance, Reimbursement, Finance, BD, Legal, and HR. Build deep working knowledge of how each function operates through the projects you lead.
• →Operate with AI: Drive results in ambiguous, fast-moving environments. Use first-principles thinking and AI-native fluency to move faster than the company would otherwise be able to.
• →CEO and Executive Partnership: Participate in CEO meetings, present to the executive team on an ongoing basis, and serve as a trusted thought partner to the CEO and Chief of Staff on company-shaping decisions.

• 6-10+ years of building or operating experience, with a track record of exceptional impact in entrepreneurial or builder-oriented environments
• One of the following backgrounds: founder of a company that has since been acquired, wound down, or moved on from; senior executive (COO, CPO, VP-level) who joined a top scaleup as one of its first 5 to 10 employees; or top-tier management consultant from MBB or a top boutique firm with healthcare or life sciences exposure, with some operational experience under your belt. 
• First-principles thinker with exceptional analytical horsepower
• Builder mentality — bias to action, comfort with ambiguity, ability to operate without a playbook
• AI-native fluency in using AI tools to move faster and amplify individual leverage
• Strong written and verbal communication, including with executives and the Board
• Genuine interest in molecular diagnostics and the BillionToOne mission
• On-site position (relocation to SF Bay Area required)

• Prior exposure to healthcare, life sciences, molecular diagnostics, or other regulated industries
• Track record of building 0 to 1 — new products, new functions, new business lines, or new operating mechanisms
• Existing network in the founder community, YC ecosystem, or top scaleup operating community

Unity Complete™ is the only non-invasive prenatal screen capable of assessing fetal risk for both common recessive conditions and aneuploidies from a single maternal blood sample.
Unity Confirm™ enables non-invasive confirmation for high-risk screening results through the capture of intact circulating fetal cells using BillionToOne’s Fetal Cell Capture™ Technology.
Our Northstar® liquid biopsy test uniquely combines treatment selection with real-time monitoring, giving oncologists unprecedented precision in cancer care.

From $0 to $400M+ annualized revenue run-rate in just 6 years. In 2025, we completed one of the most successful IPOs for a medical diagnostics company, building on nearly $400M in private funding,including our $130M Series D in 2024 and backed by world-class investors including Hummingbird, Adams Street Partners, Neuberger Berman, Baillie Gifford, and Premji Invest.

Forbes named us one of America's Best Startup Employers for 2025 and we're Great Place to Work certified, with 100% of our people willing to go the extra mile, even as we've scaled to over 700 employees.

Headquartered in Menlo Park with facilities in Union City, CA, and a new lab opening in Austin, TX in 2027, we're continuing to push the boundaries of what's possible in molecular diagnostics. We're just getting started.

Ready to help us change the world, one molecule at a time? Learn more at billiontoone.com