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Iterative Health is a healthcare technology and services company powering clinical research acceleration across 100+ sites in the US, Europe, India, and Australia. The company combines deep clinical trial expertise with AI to connect pharmaceutical sponsors with high-performing research teams, expediting access to novel therapeutics. Iterative Health is headquartered in Cambridge, Massachusetts and New York City with 250+ employees worldwide.
The Senior Research Budget Specialist is a strategic partner to sites within Iterative Health's growing domestic and international network, taking ownership of complex, high-value clinical trial budget negotiations and contract payment terms across the portfolio. This role demands deep understanding of site-level trial operations, sharp negotiation instincts, and ability to navigate sophisticated sponsor and CRO relationships across multiple geographies.
Key responsibilities include:
- 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 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 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
- Contribute to 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
The role is hybrid with in-office collaboration two days per week in Cambridge, NYC, or Southlake offices.
REQUIREMENTS:
- Bachelor's degree or equivalent experience
- 4–6 years of site-side clinical research budgeting or trial finance experience, with 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 high-volume, multi-priority workload across regions simultaneously
- Self-starter with strong ownership, accountability, and 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 compliance
- Experience building or improving budgeting processes or tools in a startup or high-growth environment
