The Senior Clinical Research Budgets Specialist is a seasoned, strategic partner to the sites within Iterative Health's growing domestic and international network - taking ownership of the most complex, high-value clinical trial budget negotiations and contract payment terms across the portfolio. This role demands a deep understanding of site-level trial operations, sharp negotiation instincts, and the ability to navigate sophisticated sponsor and CRO relationships across multiple geographies. The ideal candidate brings 4-6 years of hands-on clinical research budgeting experience, a track record of independently resolving complex financial and contractual challenges, and the judgment to operate with confidence where precedent is limited and the stakes are high.
Where You'll Drive Impact - Lead development, review, and negotiation of site-level clinical trial budgets and payment terms for high-value and complex studies across U.S. and international research sites.
- Serve as the internal expert on complex budget scenarios - including multi-country studies, novel endpoints, investigational devices, and non-standard sponsor payment structures.
- Interpret sophisticated study protocols, schedules of assessments, and evolving study requirements to construct accurate, defensible, and competitive site budgets.
- Proactively identify gaps, inconsistencies, or underrepresented cost considerations and drive resolution with sponsors, CROs, and internal stakeholders.
- Ensure budgets appropriately capture all site costs including per-patient procedures, startup activities, administrative fees, and pass-through expenses.
- Review and manage budget and payment amendments as studies evolve, including escalated or disputed items.
- Account for country-specific considerations such as currency, tax/VAT, payment cadence, and local site practices across geographies.
- Serve as a senior point of contact for sponsor and CRO budget discussions on complex or high-priority studies.
- Support alignment between Clinical Trial Agreements (CTAs) and negotiated budget and payment terms.
- Navigate sponsor pushback, non-standard terms, and escalated disputes with confidence and professionalism.
- Maintain clear documentation and audit-ready records throughout the budget lifecycle.
- Collaborate with site leadership, research coordinators, regulatory teams, and finance partners to support timely study start-up across competing priorities.
- Contribute to the development of scalable budgeting tools, templates, and processes that improve consistency and efficiency across the network.
- Support and provide informal guidance to junior Budgets Specialists on complex scenarios as needed.
What You Bring to the Team- Bachelor's degree or equivalent experience.
- 4-6 years of site-side clinical research budgeting or trial finance experience, with a focus on complex or high-value negotiations.
- Deep understanding of site-level clinical trial operations across domestic and international geographies.
- Proven ability to independently lead complex budget negotiations with sponsors and CROs.
- Strong judgment in ambiguous situations - able to assess risk, make sound calls, and drive issues to resolution.
- Excellent communication and stakeholder management skills across internal and external partners.
- Ability to manage a high-volume, multi-priority workload across regions simultaneously.
- Self-starter with strong ownership, accountability, and the ability to build or expand on limited structure.
Preferred Qualifications- Experience supporting complex multi-country or international clinical research budgets.
- Familiarity with VAT, currency exchange, and regional payment norms across European markets.
- Experience using CTMS platforms, particularly RealTime.
- Familiarity with Medicare Coverage Analysis (MCA) or billing cmpliance.
- Experience building or improving budgeting processes or tools in a startup or high-growth environment.
How We Work - Collaborative and low-ego team environment
- High ownership and accountability culture
- Fast-paced and highly iterative growth environment
- Open communication and continuous learning mindset
- Mission-driven organization focused on improving patient outcomes
- Comfortable navigating evolving business priorities and opportunities
Benefits That Support You We believe great teams do their best work when they feel supported - professionally and personally.
- Hybrid work environment with in-office collaboration two days per week in either our NYC, Cambridge or Southlake office
- Comprehensive medical, dental, and vision coverage, with up to 80% of premiums covered by Iterative Health
- Mental health and wellness support through Spring Health
- Health HSA or FSA options, and commuter FSA contributions supported by Iterative Health
- Unlimited PTO, 12 company holidays, and a company-wide shutdown between Christmas and New Years
- 401(k) program with a company match of up to 3% (up to $3,000 annually)
- Weekly in-office lunch benefit every Tuesday
- 100% company-paid short-term and long-term disability coverage
- Annual wellness and professional development stipend to support your health and growth
- And more!
