Executive Search for Venture Capital in the Healthcare Market

Early-stage growth companies are supported by a small team of founders who are simultaneously responsible for product, sales, financing and culture. With each round of financing, this constellation changes: decisions have to be delegated, processes formalized and areas of responsibility cut without losing the speed that has made the company investable at all.

At the latest from the Series B phase, it becomes apparent that founder energy alone is no longer sufficient. A company with thirty employees can still be managed from the core; a company with three hundred employees in several countries does not. The transition to a scalable organization is not a question of tools, but of the management structure – and thus a question of which people assume decision-making rights at which point.

In 2025, the European Commission presented a “Startup and Scaleup Strategy” that reorganizes the framework for growth companies in Europe. It defines five fields of action: better framework conditions, access to finance, access to talent, access to infrastructure and market access [1]. The conclusion behind this is indisputable: Europe is strong in research and early stages, but often loses ground exactly where a Series A would have to become an international market leader.

In parallel, the European Innovation Council directly addresses this growth gap with the instrument “STEP Scale Up”. Around 300 million euros are planned for 2025 and around 900 million euros for the period 2025-2027. Individual tickets are between 10 and 30 million euros and are expected to mobilize rounds between 50 and 150 million euros [2]. For leaders in VC companies, this means that capital for scaling is increasingly available — the congestion resource is the ability to translate that capital into structure, team and market presence.

The first management level above the founding team — often VP or C-level roles — is not a copy of classic corporate structures. It must speak two languages at once: that of the founding team, which has shaped a product and a market, and that of a growing organization that needs decision-making, targeting systems and reporting structures.

In practice, this means that a VP Sales from an established group is not automatically a resilient choice for a Series B company. Those who are accustomed to working with sophisticated processes, enablement teams and stable pipelines often underestimate how much setup actually has to be done themselves in a scale-up role. Group experience is valuable – but it is not proof of scale-up fit.

Conversely, pure start-up experience is rarely enough to carry an international organization from Series B onwards. What is needed are personalities who have already accompanied a development from a few dozen to several hundred employees at least once, understand the reporting requirements of institutional investors and can actively negotiate the decision-making rights between the founding team and management level.

From the Series B phase onwards, three functional areas in particular become more professional. The first institutionalized CFO is usually the focus: he is responsible for investor communication, KPI definition, forecast quality and the preparation of later rounds or an exit. Professionally in demand are candidates who simultaneously master growth financing, international consolidation and robust board reporting.

A COO or Chief of Staff takes over the operational consolidation: processes, systems, governance and scaling of people operations. In many health and biotech contexts, a commercial leadership role is added, which is responsible for market entry in several countries – usually as Chief Commercial Officer or VP International.

Internationalization is not a by-product, but its own management task. The first foreign expansion often decides whether a company is taken seriously as a European candidate for global rounds. Whoever fills the first management level, in truth also fills the basis for the next two rounds of financing.

Culture fit is the most misunderstood term in growth phases. He does not mean that a person “fits in the team”, but that he can carry the decision logic, the pace and the ambiguity tolerance of the company without diluting it. In practice, this can only be checked if roles, expectations and actual leadership situations are described concretely – not evaluated abstractly.

Specialised executive search works at this point with structured references, situation interviews and a clear separation between professional suitability and fit to the specific maturity level. Gut feeling alone is too expensive in VC situations: Misoccupations not only cost time, they cost runway and often trust with existing investors.

Before each mandate for a VC-funded company, the founding team and board should answer the same basic questions: What decision-making rights do this role migrate from the founding team to the new management level? Which milestones of the next round depend directly on this line-up? In which countries must the role be effective in twelve months?

Equally important are the questions that are often skipped: How is the reporting line regulated between CEO, board and lead investor? What expectations of reporting frequency and depth does the investor have? And which VP level will the new leader have to build himself in the first nine months? Clarity at this point shortens any search and increases the likelihood that the right personality will be found.

Starting with the Series B phase, the first management level decides on the ability of a company to shape a resilient, internationally scalable organization from a successful early phase. The European framework, from the EU strategy to the instruments of the EIC, significantly improves the conditions for this. However, the actual work remains the individual personnel decision: soberly prepared, structured checked and personally guided.