Fractional CIO

About TXM ER & Hospital

TXM ER & Hospitals is a physician-owned healthcare company developing a new 12-bed microhospital in the Austin, Texas market. The facility is under construction and targeting an opening in November. We are building a modern, physician-led hospital designed around excellent patient care, operational accountability, speed, and thoughtful use of technology.

The Opportunity

We are seeking an experienced fractional healthcare CIO, senior healthcare technology executive, or IT owner's representative to lead technology planning and readiness for our first hospital. This is not a traditional MSP sales or account-management role.

You will represent TXM's interests, work directly with the CEO and VP of Operations, coordinate internal stakeholders and outside vendors, and build a practical technology foundation that can be repeated as TXM grows.

What You Will Do

Assess and document the current Microsoft 365, Entra ID, Azure, domain, licensing, billing, and administrative-access structure.

Determine whether TXM should retain and remediate the existing Microsoft tenant or create a clean TXM-controlled environment.

Ensure TXM maintains institutional ownership and administrative control of critical technology assets.

Develop the technology roadmap and target architecture for a greenfield hospital opening.

Coordinate technology requirements with construction, clinical operations, leadership, and clinical-system vendors.

Evaluate and normalize IT vendor and MSP proposals, identify gaps or unnecessary services, and recommend the best operating model.

Define network, wireless, identity, endpoint, cybersecurity, backup, disaster-recovery, support, and documentation standards.

Identify long-lead decisions and protect the November opening schedule.

Select and supervise specialized technical resources and managed-service providers.

Create concise executive dashboards, risk registers, decision logs, budgets, and implementation plans.

Build a repeatable technology blueprint for future TXM hospitals.

First 60-Day Outcomes

1. Current-state technology and Microsoft ownership assessment.
2. Keep-versus-rebuild Microsoft tenant recommendation and transition plan.
3. Construction technology critical-path review.
4. Business, clinical, and technical requirements summary.
5. Target-state architecture and cybersecurity baseline.
6. Normalized comparison of existing vendor proposals.
7. MSP scope, selection criteria, and vendor recommendation.
8. Technology budget, procurement plan, risk register, and opening-readiness dashboard.
9. Defined testing, downtime, escalation, and go-live support plan.
10. Source out insurance coverage.

Required Experience

Senior technology leadership experience in a hospital, specialty hospital, microhospital, health system, or similarly complex 24/7 healthcare environment.

Direct experience opening a healthcare facility or leading a major hospital technology implementation.

Strong working knowledge of Microsoft 365, Entra ID, Azure governance, networking, endpoint management, cybersecurity, backup, and business continuity.

Experience coordinating EHR, PACS, laboratory, pharmacy, imaging, interfaces, or related clinical systems.

Experience managing MSPs, low-voltage vendors, construction teams, and specialized technical contractors.

Ability to translate technical issues into clear executive decisions, tradeoffs, budgets, risks, and timelines.

Understanding of HIPAA security and healthcare operational continuity.

How We Work

Patient-centered and physician-empowered.
High ownership, integrity, urgency, and accountability.
Practical and execution-focused rather than theoretical.
Comfortable challenging assumptions respectfully and recommending a clear path.
Committed to simple, scalable systems rather than unnecessary complexity.
Strong documentation and transparent communication.

Engagement

Fractional contract engagement.
Approximately 10-20 hours per week initially, adjusted to project needs.
Remote with periodic on-site work in the Austin area.
Initial focus on the first 60-90 days, with potential for a longer-term advisory relationship as TXM grows.
Reports directly to the CEO and works closely with the VP of Operations and internal stakeholders.

To Apply

Please include:

A concise summary of your healthcare technology leadership experience.
Specific examples of hospital openings or major healthcare implementations you personally led.
Your approach to Microsoft tenant ownership, vendor governance, and preventing vendor lock-in.
Your availability over the next 60-90 days.
Your proposed hourly or project-based rate.
Two or three healthcare references.
Any current reseller, MSP, hardware, licensing, or vendor relationships that could create a conflict of interest.