VP, Clinical Operations search

A VP of Clinical Operations search is almost never a search for a title. It is a search for one of two quite different people, and companies often start looking without having decided which one they need.

The builder walks into a function that barely exists. Three studies, a CRO relationship nobody is managing, no SOPs worth the name, and a CMO who needs the whole thing to be real in nine months. The operator inherits a function of forty people that works, and has to make it work at twice the scale without breaking it.

Both are legitimate VPs. Very few people are genuinely good at both, and a shortlist built without choosing produces four impressive resumes that all feel slightly wrong in the room. That is the most common reason this search stalls.

What we actually assess

• Scope owned, not scope adjacent. Plenty of candidates have a VP title inside a large pharma where they owned one therapeutic area of one function. That is not the same job as owning clinical operations at a company of 60 people. We establish what they personally decided versus what they contributed to.
• CRO relationship management under pressure. Anyone can describe a good CRO partnership. We ask what they did when a CRO missed three consecutive enrollment milestones, and listen for whether they escalated, restructured, or simply reported it upward.
• Budget and forecast credibility. A VP at this level owns a clinical budget in front of a board. Whether they have carried that number, defended it, and been wrong about it in public is a real dividing line.
• Hiring and holding a team. The VP who arrives and loses three of the five people already there has cost you more than the vacancy did.
• Regulatory-facing composure. Not regulatory expertise, which is a different function, but the ability to sit in an inspection or an agency meeting and answer for how the trials were run.

Where these searches go wrong

The spec is two jobs

Deep operational execution plus board-level strategic presence plus first-hand IND to BLA experience plus a specific therapeutic area plus on-site in a metro with four biotechs in it. Each requirement is reasonable. Together they describe about nine people in the country, six of whom are not moving.

The comp band is one cycle behind

VP clinical operations compensation moved considerably over the last few years, and a band set from an internal grid rather than the live market quietly removes the top half of the pool. You do not find out from a rejection, you find out from silence.

The reporting line is the real problem

A VP asked to report into a VP rather than the CMO or COO will read that as a title, not a seat. Strong candidates decline for this reason and rarely say so directly, which is exactly why weekly decline reporting matters more than shortlist volume.

How we run it

We start by settling the builder-versus-operator question with the hiring manager, because that decision determines the entire market map. Then we build the list of people who have done the specific version of this job at a comparable stage, approach them directly, and interview against the real requirements rather than the job description.

You get a short list, typically inside two weeks, with a written assessment on each person including what we are not sure about. If the market tells us the spec or the band is the problem, you hear that in week two rather than month four.