Paradigm Health is rebuilding the clinical research ecosystem by enabling equitable access to trials for all patients. Our platform enhances trial efficiency and reduces the barriers to participation for healthcare providers. Incubated by ARCH Venture Partners and backed by leading healthcare and life sciences investors, Paradigm’s seamless infrastructure implemented at healthcare provider organizations, will bring potentially life-saving therapies to patients faster.

Our team hails from a broad range of disciplines and is committed to the company’s mission to create equitable access to clinical trials for any patient, anywhere. Join us, and bring your expertise, passion, creativity, and drive as we work together to realize this mission.

About the role

The Senior Staff Accountant is a hands-on, detail-driven role responsible for the integrity of Paradigm Health's financial records and the execution of core accounting and revenue recognition processes. We're looking for someone with a strong background in the Contract Research Organization (CRO) or pharmaceutical industry who can step directly into the complexity of clinical trial revenue. Reporting to the VP, Financial Operations, this individual will own day-to-day revenue recognition operations in the NetSuite Advanced Revenue Management (ARM) module, ensure compliance with ASC 606 across complex, multi-element clinical trial contracts, manage complex clinical trial milestones, and serve as the primary point of contact for planning and managing the year-end financial statement audit with Paradigm's independent audit firm. This is an individual-contributor role that requires someone comfortable rolling up their sleeves, working directly in the general ledger, and taking ownership of outcomes rather than delegating them.

What you will do

Revenue Accounting & ASC 606 Compliance

NetSuite ARM Ownership: Manage and execute revenue recognition configurations, rules, and arrangements within the NetSuite Advanced Revenue Management (ARM) module, including revenue arrangement setup, allocation, and schedule maintenance.

ASC 606 Application: Apply revenue recognition standards to complex, multi-element contracts common in CRO and pharma environments — including milestone payments, pass-through costs, and upfront fees — across Paradigm's service configurations (Planning, Recruitment, Study Conduct/eSource, and SPIRE/Phase 4).

Contract Review: Analyze customer contracts and work orders to determine appropriate accounting treatment and revenue schedules, and ensure new contracts, amendments, and pricing configurations are reflected correctly in the accounting records.

Tracking Metrics: Monitor project progress, units of service, and investigator fees to align actual clinical trial milestones with monthly revenue recognition

Financial Reporting & Month-End Close

Journal Entries: Prepare and post month-end journal entries for deferred revenue, accrued revenue, and unbilled receivables, along with other close-related entries and supporting schedules.

Reconciliations: Reconcile complex balance sheet accounts — including deferred revenue, unbilled receivables, and accounts receivable — tracking variances back to NetSuite ARM and resolving discrepancies between ARM output and the general ledger.

Flux Analysis: Perform monthly variance analysis on revenue and cost of goods sold (COGS) lines to support management reporting.

AR & Billing: Own all accounts receivable, billing, and collections analysis, including monitoring of AR balances tied to billing schedules and standard DSO terms.

AP & Vendor payments: Own all accounts payable workflow using RAMP. Ensuring all vendor spend meets procurement compliance.

Audit & Internal Controls

Serve as a key liaison for the year-end financial statement audit: plan and manage the audit timeline in coordination with the CFO and Associate Director of Finance and Accounting independent audit firm.

Audit Support: Prepare audit-ready schedules, PBC (prepared-by-client) items, documentation, and system reports for external auditors for quarterly and year-end audits.