RootBound Health
Welcome aboard.
Your first ninety days
You've seen what RootBound is and what this role owns. This is how you step into it — week by week, system by system, relationship by relationship — until the whole machine is running through you.
Onboarding companion to the Role Overview
I built RootBound because I lived the gap it closes. What I need from you isn't to memorize it — it's to hold it together and make it bigger than one founder can.
The first ninety days are deliberately paced: land and learn, then take the controls, then build and extend. Nobody expects you to drive on day one. They expect you to listen first, earn the chart, and then never let an episode fall through. This deck is your map for getting there.
Patients get discharged into instability, care plans don't match real life, and harm happens in the hours and ZIP codes no clinic reaches. RootBound exists to interrupt that pattern.
Complementary to the safety net, never duplicative. Every program, SOP, and metric in this deck is one expression of that idea — and your job is to keep all of them pointed at it.
What you own from day one
The ninety-day plan that follows is simply how you pick up these four, one layer at a time — without dropping the chart on the way.
Your onboarding — the 1099 basics
RootBound engages the Director — and most of the team — as 1099 independent contractors, not W-2 employees. The same basics apply to anyone you bring on; get them on file before the first shift.
IRS Form W-9 → year-end 1099-NEC; no tax withheld at source
Direct-deposit / ACH + emergency contact
Licenses, DEA, and a malpractice Certificate of Insurance
Background + OIG / SAM exclusion check
The three root barriers + the financing-disclosure rule
System access — Healthie, Radix, RPM, drive, email — with MFA
Invoicing: agreed rate, monthly cadence, net terms
Equipment & expense policy
What 1099 means: you carry your own taxes (self-employment + quarterly estimates), health coverage, retirement, and time off — the agreement, not a benefits package, sets your terms. Paperwork to onboarding@rootboundhealth.com.
Ninety days, three movements
Days 1–30 — land & learn
Days 31–60 — take the controls
Days 61–90 — build & extend
The operating rhythm
The clinic runs on a fixed cadence — the dashboard is the single source of truth, updated monthly and reviewed against it. As Director you chair the operational beats; the founder and board hold the strategic ones.
| Cadence | What happens | You own / co-own | Source |
|---|---|---|---|
| Daily | Red-flag triage, after-hours handoff review, reconciliation | Coordinator → you for escalation | Healthie |
| Weekly | Ops review — open episodes, dispute queue, RBCA enrollment log | Director (chair) | Weekly ops dashboard |
| Monthly | Tier-mix, contribution margin, commissions, Foundation cash | Director + bookkeeper | Monthly board pack |
| Quarterly | Mystery shop, inter-entity FMV review, Foundation board meeting | Director + founder + counsel | Risk register |
| Annually | Governing-agreement review, sponsor renewals, compliance training | Founder + counsel; you execute | Compliance calendar |
One dashboard, three audiences
By the numbers
| Service line | Year 1 | Year 2 | Gross margin | Primary drivers |
|---|---|---|---|---|
| Aesthetics (Glow) | $500–800K | $1.0–1.5M | 55–70% | Neurotoxins, fillers, microneedling, PRP, GLP-1 |
| Primary care (DPC) | $600–800K | $1.0–1.4M | 55–65% | Subscriptions, E/M, labs, procedures |
| TLC program | $480–720K | $960K–1.4M | 65–75% | TCM + hospital contracts + RPM + CCM |
| Behavioral health | $350–500K | $600–900K | 70–80% | Evals, therapy, med mgmt, MAT |
| Product sales | $80–150K | $200–350K | 40–50% | Skincare, supplements, retail platforms |
You own the clinic to contribution margin — aesthetics is the cash engine that cross-subsidizes sliding-scale primary care and the rural mission. Pre-launch investment runs $250–400K; protect the runway.
Systems & access — set up in week one
The Follow-Up SOP in practice
This is the connective tissue under all six service lines. Every episode runs one of four parallel tracks, follows the three-attempts-then-escalate rule, and is held by a single named owner from open to closure.
Red-flag routing — the path to you
For TLC specifically, a High or Critical risk score pulls first contact to ≤ 24 hours — the risk score overrides the condition window upward, never down. When in doubt, escalate early; the system is built to absorb it.
Your people — the inner team
| Role | What they own | Your relationship to them |
|---|---|---|
| Founder & Medical Director | Clinical authority, vision, board, strategic relationships | You report to him; he hands you operations to free his |
| Care Coordinator | Front line — scheduling, follow-up outreach, dispute queue, reconciliation | Your closest operational partner; escalates to you |
| Insurance Producer (RBCA) | All coverage solicitation — ACA, indemnity, accident products | The boundary partner; all insurance talk deflects to them |
| Bookkeeper | QuickBooks, inter-entity coding, monthly financials | Co-owns the monthly board pack with you |
| Counsel | Three governing agreements, FMV basis, compliance review | Quarterly partner on inter-entity and regulatory hygiene |
In your first 30 days, sit with each of them 1:1 before you change anything they touch. The coordinator and producer relationships are the two you lean on most — invest there first.
The directory — reach them here
Everyone below reports into operations through you. The founder, Kal Elliott, is the only one who doesn't — you report to him.
(425) 699-6873 · ext. 2
(425) 699-6873 · ext. 3
(425) 699-6873 · ext. 4
(425) 699-6873 · ext. 5
Names, direct emails, and extensions are placeholders on the standard @rootboundhealth.com pattern — confirm against the live roster before sharing.
Build the team — hire by trigger, not by hope
Every hire is gated to a volume trigger, so payroll tracks demand instead of leading it. Your job is to watch the trigger metrics and pull each role in on time — never early, never late.
| Role | Volume trigger | Target |
|---|---|---|
| RN Care Manager | 40 patients / week capacity exceeded | Month 4 |
| Medical Assistant | Provider clinical time saturated | Month 5 |
| Second provider (NP / PA) | Panel full, or aesthetic demand | Month 6 |
| Licensed Esthetician | Aesthetic volume demand | Month 6–12 |
| Community Health Worker | Rural / social-needs caseload | Month 8 |
| PMHNP (psychiatric) | Behavioral health panel full | Month 9–12 |
| Administrative Coordinator | Ops load beyond the coordinator | Month 10 |
| Front desk / scheduling | Front-of-house volume | Month 12 |
Who to know first — sequenced
Sequence is the point: referral partners first (they feed live episodes), then access partners, then capital. Keep a 2:1 pipeline — two prospects in motion for every relationship you're counting on.
What you must never do
The three legal entities only stay safe if their root barriers stay clean. These are the bright lines — break one and you put the DPC license, the producer license, or the Foundation's status at risk.
The compliance calendar
| Cadence | Standing check | Owner |
|---|---|---|
| Weekly | RBCA enrollment log & dispute queue reviewed; financing receipts reconciled | Director + producer |
| Quarterly | Mystery shop — the "is this insurance?" deflection script tested live | External consultant |
| Quarterly | Inter-entity expense review — FMV reasonableness on every transfer | Founder + counsel |
| Quarterly | Risk register refreshed; top-8 mitigation playbooks reviewed | Director |
| Annually | All three governing agreements reviewed; Reg Z / TILA staff training | Counsel; you execute |
Decision rights — yours, shared, hers
When a call is ambiguous, default to surface early — the cost of an over-shared decision is a five-minute conversation; the cost of an under-shared one can be a wall.
What "good" looks like
RootBound Health
Listen first. Earn the chart. Then never let go.
The ninety days are a runway, not a test. Hold the programs together, keep the root barriers clean, turn relationships into reach — and the rest of the role is yours to write. Welcome to RootBound.
10212 5th Ave NE, Suite 116 · Seattle, WA 98125
(425) 699-6873