Senior Financial Analyst, Clinical Finance

Drug development shouldn’t be guesswork, not when patients are waiting.

Pathos is building a next-generation biotech with AI at the core. Not as a feature, but as the operating system for how medicines get developed. We believe most drugs don't fail because the science was wrong. They fail because they were tested in the wrong patients, with the wrong assumptions, in trials that couldn't answer the real question: who benefits, and why?

Pathos exists to change that. We're building the largest foundation model in oncology and pairing it with proprietary AI systems, deep oncology expertise, and 200+ petabytes of multimodal data linked to patient outcomes, so we can make development decisions with more precision, much earlier.

This is not theoretical. We’re well-capitalized and have the leadership to build a generational company. We invest in and advance our own clinical-stage programs, using our AI platform to sharpen trial design, patient selection and biomarker strategy. So therapies reach the patients most likely to benefit, sooner.

How We Build

Pathos does not operate like a traditional biotech. There is no middle management. There are no layers of approval. The company is designed, from the ground up, around small teams of 2–4 subject matter experts who each command hundreds of AI agents to do the work that used to require dozens of people.

Everyone builds. Everyone ships. Every function at Pathos — from clinical execution to asset selection to the foundation model itself — runs on this model. Our product velocity delivers meaningful outcomes in hours instead of weeks. This is not a future aspiration. It is how we operate today.

The people who thrive here are operators: deep experts who can specify what needs to happen, orchestrate AI agents to execute at scale, and make high-judgment calls that compound over time. If you have spent your career building and shipping AI systems at scale, this is the environment where that experience becomes a superpower.

About the role

We are seeking a Senior Financial Analyst, Clinical Finance to own the financial side of our clinical vendor base, from forecast and contract review through invoice review and monthly accruals.

This is a step up for an analyst with 2 to 4 years in biotech or pharma finance who wants to own a process end to end. You will report to our SVP of Finance and partner day to day with Clinical Operations, the accounting team, Legal on contract terms, and our CROs and vendors. The core of the job is knowing what is changing in each trial and making sure the budget, forecast and accruals keep pace. At Pathos, that work does not run on manual spreadsheets and inbox triage. You will use AI agents and automation to build repeatable processes that reduce errors, improve accuracy and surface insights we would otherwise miss.

What You Will Do

Clinical Spend Forecasting

● Build and own the clinical trial forecast by vendor, study and cost category (CRO services, pass through costs, site grants, lab, technology, imaging, IRB).

● Hold a regular dialogue with Clinical Operations to capture changes as they happen: enrollment pace, site activation, protocol amendments, scope changes and timeline shifts.

● Translate each trial change into its cost and timing impact, and keep forecasts and estimates on the latest plan, not the one in the original contract.

● Produce the clinical inputs to the annual budget, quarterly reforecasts and cash runway models.

Vendor Spend and Invoice Review

● Maintain a tracker for every clinical vendor that matches each invoice line to its MSA, SOW, work order and executed change orders, and tracks remaining contract value by category.

● Support the clinical AP process: track incoming invoices in our AP platform, tie them to their POs and study, catch duplicates, and route them to Clinical Operations for review.

● Review vendor billing by hours, units, milestones and pass through costs against the contract and real study progress, and flag resource use that looks out of scope, overstaffed or ahead of the work before invoices are approved.

● Track CRO prefunded deposits and site grant funds: what has been prepaid, applied and credited back.

● Keep a running exceptions log and escalate each item for resolution with the vendor or a Pathos decision.

Actuals Versus Forecast

● Close the loop each month: compare invoiced and accrued spend to forecast by vendor and category, and explain the variances.

● Keep the clinical spend dashboard current and reconciled to Pathos billing and accounting platforms.

● Prepare monthly spend, burn and variance reporting for the SVP of Finance and Clinical Operations leadership.

Clinical Procurement

● Support the finance side of contracting: review SOW and change order budgets, compare pricing and rate cards to prior work, flag issues for the SVP of Finance, and confirm budget availability before signature.

● Provide vendor, study and budget details for purchase order setup in Bill.com.

Clinical Accruals

● Prepare the monthly clinical accrual for each vendor, built from vendor reported work, unit and milestone data, site activity and Clinical Operations input, for review by the SVP of Finance.

● Maintain accrual and prepaid schedules that support the accounting team’s journal entries and reclasses, and reconcile them to subsequent invoices.

● Support the annual audit and investor diligence with clear, documented clinical expense support.

Who You Are

Required Qualifications

● Bachelor’s degree in finance, accounting, economics or a related field.

● 2 to 4 years as a financial analyst at a biotech, pharma company or CRO, with direct exposure to R&D or clinical trial costs across multiple studies.

● Working knowledge of how clinical trials are contracted and billed: MSAs, SOWs, change orders, pass through costs, site payments and prefunded deposits.

● Experience building forecasts and variance analyses.

● Understanding of accrual accounting and month end close. You can build an accrual from operational data with documented support.

● Advanced Excel: you build models others can follow, audit and update.

● A strong interest in using AI tools and automation in daily work, with examples of workflows you have streamlined or rebuilt to cut manual effort and errors.

● The confidence to question a vendor invoice and the judgment to work collaboratively with Clinical Operations.

Preferred Qualifications

● Hands on clinical accrual ownership for one or more studies.

● Experience with QuickBooks Online and Bill.com, or similar ERP and AP tools.

● Exposure to oncology trials.

● Experience on a small finance team where you covered several roles.

● CPA progress or MBA coursework.

What Success Looks Like

In your first year:

● Within 90 days, every active vendor has a current tracker reconciled to its contract, the GL and the spend dashboard.

● No overrun reaches an invoice unflagged, and trial changes show up in the forecast and accruals the same month.

● Clinical accruals close each month with documented support and no material true ups at audit.

Location

This is a hybrid role based in our New York City office, with in-person attendance on Tuesdays, Wednesdays and Thursdays.