BillionToOne - Director of Commercial Strategy and Operations

A Rare Opportunity to Shape the Future of Genomics

Join a team of brilliant, passionate innovators determined to transform healthcare. At BillionToOne, we've built a category-defining, publicly traded company on Nasdaq where transparency fuels trust, collaboration drives breakthroughs, and every contribution moves the needle on our mission to make life-changing diagnostics accessible to all. We don't just aim for incremental improvements; we build products that are 10x better than anything that exists today.

Our scientists, engineers, sales executives, and visionaries are united by an unwavering commitment to changing the standard of care in prenatal and cancer diagnostics. This is where cutting-edge science meets human compassion, and every innovation you contribute helps remove the fear of the unknown from some of life's most critical medical moments.

If you’re driven by purpose, energized by innovation, and ready to help shape the future of precision medicine at scale, this is where you belong.

About the Role

We’re hiring a Director of Commercial Strategy and Operations to build and lead a brand-new function: the strategic and operational backbone of our ~250-person Prenatal field organization. You’ll be the direct partner to our VP, Commercial Sales–Prenatal, and you’ll define what excellence looks like in commercial strategy and operations at BillionToOne. There’s no playbook to inherit — you’ll design it.

Responsibilities

• Partner with the VP, Commercial Sales–Prenatal to set strategy, annual plans, and the operating cadence (WBRs, MBRs, QBRs) that drives revenue and account expansion.
• Lead territory design and quarterly rebalancing for a 250-person field team scaling into new geographies, with dotted-line management of the Salesforce admins who power the data.
• Own incentive compensation design and quarterly quota setting — building plans that reinforce strategic priorities and stand up to finance and field scrutiny.
• Direct sales analytics, dashboards, and reporting, working closely with the commercial data science team to turn field activity into insight and insight into action.
• Use data to go from "what" to "why" — and from "why" to "what we should do about it" — synthesizing tangible recommendations from field performance, deal outcomes, competitive signal, and product launches.
• Treat AI as a force multiplier — building a function that produces several multiples of the analytical output of a traditional sales ops team.
• Program-manage the highest-priority cross-functional initiatives — acceleration programs, health system adoption, EMR integration — and liaise to bring field signal into Product, Marketing, and Market Access.

Qualifications

• 10+ years across sales strategy, commercial operations, revenue operations, or top-tier management consulting — with material time partnering closely with senior sales leadership.
• Proven track record designing territories, setting quotas, and building variable comp plans for field sales orgs during rapid growth.
• Hands-on analytical rigor: you can do data analysis with AI, build a model in Excel, debug a Salesforce report, and present the answer to the VP in the same day.
• Experience leading high-performing analytical teams, including data scientists or commercial analysts.
• Excellent communication and executive presence — credible from individual contributor to C-suite.
• A builder's mindset: high comfort with ambiguity, and the instinct to ship a v1 and iterate.

Nice-to-Haves

• MBA or advanced degree.
• Experience in molecular diagnostics, NGS, liquid biopsy, prenatal, or oncology commercial environments.
• Hands-on experience deploying AI tools (LLMs, agents, custom workflows) inside commercial functions.
• Experience at a publicly traded company.

Benefits and Perks

• Working alongside brilliant, kind, passionate, and dedicated colleagues in an empowering environment, toward a global vision.
• Open, transparent culture with weekly Town Hall meetings.
• The ability to indirectly or directly change the lives of hundreds of thousands of patients.
• Multiple medical benefit options; employee premiums paid 100% on select plans, dependents covered up to 80%.
• Extremely generous Family Bonding Leave for eligible employees (16 weeks, paid at 100%).
• Supplemental fertility benefits coverage.
• Retirement savings program with a 4% Company match.
• Increased paid time off with increased tenure.
• Latest and greatest hardware (laptop, lab equipment, facilities).

Compensation

Total compensation package up to $471,554 per year, including a base pay range of $246,525 - $267,962 per year. This includes competitive base pay, generous equity options, and a corporate bonus program.

Equal Opportunity Employer

BillionToOne is an equal opportunity employer. We do not discriminate on the basis of race, religion, color, national origin, gender, sexual orientation, age, marital status, veteran status, or disability status.

About BillionToOne

BillionToOne is a next-generation molecular diagnostics company on a mission to make powerful, accurate diagnostic tests accessible to everyone. Our revolutionary QCT molecular counting technology enhances disease detection resolution by over a thousandfold using cell-free DNA, a breakthrough that has already transformed the lives of over half a million patients worldwide.

• Unity Complete™: The only non-invasive prenatal screen capable of assessing fetal risk for both common recessive conditions and aneuploidies from a single maternal blood sample.
• Unity Confirm™: Enables non-invasive confirmation for high-risk screening results through the capture of intact circulating fetal cells.
• Northstar®: A liquid biopsy test that uniquely combines treatment selection with real-time monitoring for precision cancer care.

Our Growth & Recognition

From $0 to $400M+ annualized revenue run-rate in just 6 years. Completed one of the most successful IPOs for a medical diagnostics company in 2025. Backed by world-class investors and recognized as Forbes' America's Best Startup Employers for 2025 and Great Place to Work certified.