Lead · Integration and operational truth
Who is accountable for the outcome end to end when it is distributed across dozens of teams, systems, decisions, and dependencies?
TKO becomes the integration and operational-truth layer for the program: reconstructing ownership, surfacing the dependencies nobody reported, naming the unresolved decisions preventing closure, testing whether reported status is supported by evidence, and establishing what ready means before anyone declares it.
Scope-dependent
Starting at $20K/month, ranging to $50K/month by complexity
Principal-led with explicit scope boundaries
The buyer and the moment
Who this is for.
For healthcare transformations whose outcome depends on many teams, applications, vendors, and decisions at once—and where every part has an owner but the whole does not.
- The outcome spans many applications, workflows, products, or delivery partners, and no single role is accountable for the whole.
- Every workstream reports green while the enterprise date is visibly at risk.
- Dependencies keep surfacing late, discovered by collision rather than by plan.
- Decisions sit unresolved for weeks because no one can say who owns them.
- Leadership cannot answer whether the organization is ready, only what each team reported.
Outputs
What the engagement produces.
- Ownership registry naming an accountable owner for every element of the outcome, including the work currently owned by nobody
- Dependency and critical-path model covering the dependencies no workstream reported
- Decision and approval log that names the unresolved decisions blocking closure
- Evidence-tested status: whether reported condition is supported by artifacts rather than assertion
- An explicit definition of ready, and testing against it
- Risk, blocker, and escalation register tied to named owners and dates
- Executive decision intelligence rather than a workstream status roll-up
What sets the fee. Fees are set against organizations and systems affected, regulatory or public deadline exposure, program spend and business consequence, number of delivery partners, degree of cross-functional accountability, testing and release complexity, executive-reporting requirements, and responsibility for readiness and escalation.
What the starting price assumes. Every engagement defines objective, deliverables, meeting and access expectations, client responsibilities, exclusions, and the decision for handoff or expansion.
Boundaries
What this engagement is not.
Stated before contracting so access, accountability, and expansion decisions are explicit.
- This is a control layer for execution, not a PMO, a reporting layer, or additional project administration.
- Scope and price reflect business impact, complexity, access, and accountability—not founder hours.
- Client executives retain line authority, budget ownership, and accountable delivery roles.
- TKO does not supply a low-cost delivery bench and does not replace accountable client executives.
- Technology delivery, specialist partners, travel, and sensitive-data controls are explicitly scoped.
Expansion path: The intended exit is a transformation whose ownership, dependencies, decisions, and readiness definition are established well enough that client leaders and delivery teams operate them without permanent dependence on TKO.
Capabilities
What this engagement draws on.
How is this different from our PMO?+
A PMO collects reported status, tracks reported dependencies, records assigned owners, and escalates overdue actions. This role reconstructs enterprise truth: it finds the dependencies nobody reported, the work with no accountable owner, and the unresolved decision preventing closure, and it tests whether status is supported by evidence. Both are necessary. They are not the same job.
Is this priced by the hour?+
No. Pricing reflects the number of organizations and systems affected, deadline exposure, the number of delivery partners, release and testing complexity, executive-reporting requirements, and how much readiness accountability transfers to TKO. Effort is estimated internally but is not the product.
Can TKO work with our integrator?+
Yes. TKO establishes and governs the operational truth across the program while internal teams and delivery partners retain their appropriate delivery accountabilities.
Other entry points
Use the smallest engagement that can answer the question.
Principal-led healthcare advisory
Start with the transformation question.
A focused working conversation about what is changing, what is stuck, and which decision leadership needs to make before more money or momentum is lost.