The work in the gap.
The best operators I've worked with can build process, lead a team, and put out three fires before lunch.
Execution isn't usually the issue. The harder question is whether those are the right processes, the right priorities, and the right fires: the ones that actually match what the leader had in mind. That gap between vision and what gets built is where things quietly break down, and it's where I do my best work.
A lot of what I do is ask the questions that don't have an obvious home. Not because no one's thought of them, but because everyone is either too close to the work or too close to each other to say them out loud. Surfacing misalignment before it becomes a problem isn't comfortable, but it's usually what unlocks everything else.
I'm Rebecca Balliet. I work as a fractional Chief of Staff and VP of Strategy for healthcare and multisite organizations, embedded part-time across operations, marketing, finance, or sales teams that have direction but need someone to drive it forward.
Before starting my practice three years ago, I was VP of Strategy at Hero Practice Services. What I learned there is that the best intentions can be thwarted by a lack of project management and structure. Priority initiatives need to be surfaced, scoped, and executed, and that work happens with and through the people on your team, not around them.
My clients tend to find me when something has been bothering them longer than it should have: the same problems surfacing on repeat, processes that live in someone's head and walk out the door when they do, a vendor decision that feels more like a gamble than a choice. They know what they want and just need someone to help them get there.
Priority initiatives surfaced, scoped, and executed — working with and through your team, not around them.
What that's looked like in practice
- Teams that went from AI-aware to AI-adopted, building new habits instead of just attending a training
- Processes pulled out of people's heads and into documentation that makes onboarding consistent and coaching specific
- Vendor decisions made with clear requirements and fewer surprises after the contract is signed
- The same problems that kept surfacing finally getting resolved at the root
Two kinds of Chief of Staff.
"Chief of Staff" means different things in different places. In some organizations, it's a senior executive assistant who manages calendars, screens email, and keeps the back office running. In others, it's the person closest to a leader's strategic work who keeps the organization moving forward. I'm the second kind, and I've never been particularly good at the first.
The work I do sits between a leader's vision and a team's capacity to execute on it. It looks like surfacing the questions no one is asking, sorting through priorities that got buried under daily firefighting, helping with a vendor decision that's overdue, or capturing the process that lives in someone's head and walks out the door the day they do.
What ties my clients together isn't industry. It's that they are mission-driven organizations doing work that matters, led by people who care about doing it right.