Senior Research Budget Specialist - Cardiology

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!