I applied online. I interviewed at BillionToOne (Del Mar, CA) in Mar 2026
Interview
The interview process is extensive and one-sided by design. It begins with an online screening quiz testing statistical and clinical knowledge, followed by a take-home assignment, and then five separate interviews spanning R&D, sales, operations, and two rounds with the CPO. Candidates are expected to demonstrate deep scientific literacy, strategic thinking, and domain expertise at every stage ...and expected to do so graciously and without complaint.
What you will not experience is any reciprocal curiosity. No one will ask what drives you, what kind of leadership environment you thrive in, or what you need to do your best work. The process is designed to extract signal from candidates, not to evaluate fit in any meaningful two-way sense.
After completing all of the above, I waited weeks for an update, followed up directly, and received silence. No rejection, no timeline, no courtesy email. For a company that presents itself as transparent and people-first, the gap between that brand and the lived candidate experience is significant.
If you make it far in this process, manage your expectations accordingly.
Interview questions [3]
Question 1
Question 1 — Sensitivity & Specificity / Bayesian PPV
"A new diagnostics company markets a test with 99% sensitivity and 99% specificity for Disease X, which occurs in 1 in 10,000 people. You receive a positive result. What is the probability you actually have the disease?" Candidates are expected to work through the Bayesian math and arrive at a PPV of approximately 0.98% — and to understand the implications for population-level screening recommendations.
Question 2 — Retrospective vs. Prospective Study Design
"Grail's Galleri assay showed 51.5% sensitivity in CCGA-3 but only 20.7–28.9% in the PATHFINDER prospective study. The assay itself did not change. What explains the drop?" Candidates are expected to discuss spectrum bias,
Walk me through your background
Tell me about a time you had to manage risk and change project direction under resource constraints
Tell me about a time you had to manage a QC error or failure
How did you scale up a test?
Tell me about a failure you had to rectify.
What question should I ask you?
OA, hiring manager meeting, two more interviews with the team, on site experiment interview and executive interview. Usually took 2 to 3 days after each round to get back to me.
Online proctored exam containing basic biology, statistics, programming topics. Followed up with a technical interview on coding with Python and did not pass. Interviewer was very pleasant to chat with.
Interview questions [1]
Question 1
Code object relational mapping functions in Python