Director of Product & Operations at First > Then. Ten-plus years building products, leading teams, and shaping strategy across healthcare, caregiving, insurance, and operational platforms.
10+
Years building products & leading teams
13
Early-stage startups guided from 0→1
5
Designers mentored into senior roles
NSF
Helped secure grant funding through product strategy
Selected work
The full case studies live in my portfolio deck. Here's the short version—what I owned, what changed, and why it mattered.
An NSF-funded digital health startup supporting caregivers of children with ADHD. Leading product strategy, operations, and design in partnership with founders and executive leadership to define product vision, roadmap, and organizational priorities.
Led product design and UX strategy for the company's pet insurance platform, Toto, translating a large-scale rebrand into a cohesive digital product while simplifying quote and enrollment workflows.
PatientNow is an enterprise healthcare platform created by merging three separate products into one experience. I led information architecture and workflow strategy across billing, inventory, scheduling, and operational systems, helping transform fragmented legacy software into a cohesive platform.
Gabbi is a women's health platform focused on improving early detection of breast cancer through personalized risk assessments and preventive care. I partnered with the founders across multiple product iterations, helping shape the product from early concepts through funding, pilot launches, and the development of a live employer platform.
Venture was an educational platform that helped teachers assess students' understanding against the NGSS science standards. I led product strategy and workflow design, transforming an Illinois pilot into a scalable platform adopted by schools nationwide.
How I work
Healthcare, insurance, and operational software don't reward pretty interfaces. They reward people who understand the systems underneath—and can make them simpler for the people using them.
01
The hardest product problems aren't missing solutions—they're missing clarity. I help founders turn ambiguity into product direction—aligning product vision, roadmap, and organizational priorities so teams know what to build and why.
02
Great design organizations don't happen by accident. They grow from trust, coaching, clear expectations, and strong cross-functional relationships. I've built design organizations from the ground up—creating hiring practices, coaching systems, quality standards, and the infrastructure that helps teams thrive. Great leadership creates more leaders by building trust and giving people the confidence to own meaningful decisions.
03
Consistency is the visible outcome of a design system; speed is the real one. The same is true of product operations. Good planning, prioritization, and cross-functional execution remove friction so teams spend less time relearning problems and more time shipping meaningful work.
Nice to meet you
I'm Director of Product & Operations at First > Then, with more than a decade of experience across healthcare, caregiving, insurance, and operational platforms. My background in biology and pharmacy studies gave me an early understanding of clinical systems, patient experience, and the operational realities behind them.
Founders and executive teams bring me in when the path forward isn't obvious. I help turn ambiguous business challenges into product vision, strategy, and organizational direction. Along the way, I've built design organizations, established product operations, mentored designers into leadership, and helped secure NSF funding through product strategy and investor storytelling.
I'm equally interested in how organizations build. I enjoy simplifying complex systems, improving how teams collaborate, and exploring how AI can eliminate busywork so people can focus on meaningful problems.
Outside of work, I'm usually chasing after Ethan, Emery, and Olivia, building something for one of my many pets (yes, it's basically a zoo), aquascaping, or tackling another DIY interior project around the house.
Download resumeHelped shape product strategy, vision, and investor storytelling supporting a successful NSF award.
Conversations with founders and leaders building the future of women's health and digital healthcare.
Community contributor and platform support for a globally recognized directory of Latinx designers, launched as a top Product Hunt product.
Pharmacy studies and a B.Sc. in Biology—the foundation behind how I read clinical systems and patient experience.
Experience
Across startups, studios, and embedded product teams—usually leading both strategy and execution.
Leading product strategy, operations, and design for an NSF-funded digital health startup.
Embedded as the sole product designer across regulated digital health initiatives.
Led product design and UX strategy for the Toto pet insurance platform.
Defined product strategy and workflow design for a clinical operations platform.
Co-founded a healthcare product studio, building a team of five while supporting 13 early-stage startups.
Delivered product strategy and UX research across enterprise consulting engagements.
Interested in working together?
© 2026 Sarah Gear Design