Iterative Health is a healthcare technology and services company powering the acceleration of clinical research to transform patient outcomes.

We built a leading performance-driven network of 100+ sites across the US, Europe, India, and Australia, conducting research directly in the communities where care is delivered across gastrointestinal, hepatology, obesity, and cardiology. By combining deep clinical trial expertise with cutting-edge AI, we connect sponsors' scientific ambitions with high-performing research teams that expedite and expand access to novel therapeutics for patients in need. Today, Iterative Health is headquartered in Cambridge, Massachusetts, and New York City with 250+ employees world-wide.

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.

• Performs related duties

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!

At Iterative Health, we’re actively working towards creating an environment that is representative of the diversity of patients our technology serves. We are focused on building an equitable and inclusive culture, and by extension, hiring process. If you require any accommodations to make the application process or interviewing experience more accessible to you, please contact CandidateAccommodations@iterative.health.