Head of SEO — Medical Accounts

Requirements:

• Available 9:00 AM to 5:00 PM US Eastern, Monday to Friday. This schedule is fixed - our clients are American and you will be on their calls. Please check what that means where you live before applying.
• Fluent in the stack: Screaming Frog or an equivalent crawler, Google Search Console, GA4, Ahrefs or Semrush, WordPress at agency scale, Google Business Profile, and structured data.
• Managed at least two people for at least a year — actually managed them, including telling someone their work wasn't good enough and keeping them on the team afterwards
• Have been the accountable person for a domain's organic performance, not a contributor to it
• Can hold a 45-minute call in English with a physician-owner who interrupts you, without a script. Advanced English (C1+) is a hard requirement, not a preference
• Technical SEO deep enough to explain a Core Web Vitals fix in terms of the asset causing it, read a log file when the crawl summary doesn't add up, and refuse a quick fix that breaks something downstream
• Understand why medical content needs a reviewer, and what happens to a practice that publishes treatment claims without one

Not a fit if: you want strategy without hands-on technical work · you don't want to be on client calls · your management experience is "mentoring juniors" · you need the agenda sent to you before you know what to prepare · you'd rather your boss delivered the hard message to your team member · you've bought links or published unreviewed AI content for a medical client and thought it was fine

What you own

• The technical standard across every account — crawl health, indexation, schema, Core Web Vitals, migrations, and the judgment calls above them
• The client relationship. You run the recurring SEO calls yourself: set the agenda, present results, defend the plan when a client pushes back, and say no when what they want will hurt them
• A team of junior SEO specialists. You assign their work, review it before it ships, and tell them directly when it isn't good enough
• Coverage. Every account has a named backup with real context, so a week of your absence moves nothing

Your first 90 days

You take over the recurring client calls. You publish an account plan and a call agenda before each one, not after. You put a QA gate in front of everything the juniors ship. You build the backup map. By day 90, nothing in the department waits on you personally to unblock it.

What we offer

• USD compensation paid via Wise, on the 15th and last day of each month
• A written 90-day review against a defined scorecard, with a raise attached to it
• Full ownership of the SEO department - you set the standard rather than inherit someone else's
• A junior team to build and lead, with real hiring input
• A direct working relationship with the founder. No layers, no politics
• Fixed hours and no on-call. When your day ends, it ends

Nice to have

Experience with medical, dental, legal or other regulated/YMYL accounts
• Google Business Profile and multi-location local SEO
• WordPress at agency scale
• Experience building a junior team from scratch, not just inheriting one
• Familiarity with AI-assisted SEO workflows and AI search visibility
• Bilingual Spanish/English — our team spans several countries

Tier3 Media is a US agency. We run SEO for medical spas, dermatology, plastic surgery and dental practices across the United States. Our clients are physician-owners: smart, busy, skeptical, and quick to tell whether the person on the call actually understands their market.

We are hiring one senior person to own our entire SEO department.