Director, Actuarial & Performance Guarantees

New York, NY

Twin Health

At Twin Health, we empower people to improve and prevent chronic metabolic diseases, like type 2 diabetes and obesity, with a new standard of care. Twin Health is the only company applying AI Digital Twin technology exclusively toward metabolic health.

We start by building a dynamic model of each person’s metabolism — drawing on thousands of data points from CGMs, smartwatches, and meal logs — that maps their personal path to better health. Guided by a dedicated clinical care team, our members have lowered their A1C below the diabetes range, achieved lasting weight loss, and reduced or even eliminated medications, all while living healthier, happier lives.

Working here

Our team at Twin Health is passionate, talented, and united by a shared purpose: to improve the metabolic health and happiness of our members. We believe in empowering every Twin to make a meaningful impact for our members, our clients, and each other, while enjoying a supportive, collaborative work environment.

Twin has been recognized not only for our innovation but also for our culture, including:
Innovator of the Year by the Employer Health Innovation Roundtable (EHIR), selected to CB Insights’ Digital Health 150, and named one of Newsweek’s Top Most Loved Workplace® .

With more than $100 million raised in recent funding, including a $53 million Series E round in 2025 led by Maj Invest, and a $50 million investment in 2023 led by Temasek, Twin is scaling rapidly across the U.S. and globally. Backed by leading venture firms like ICONIQ Growth, Sequoia, Sofina, Temasek, and Peak XV, we are building the most impactful digital health company in the world.

Join us as we reinvent the standard of care in metabolic health.

This role is a unique opportunity to own how Twin puts its outcomes on the line. Twin stands behind its results with performance guarantees, and you’ll be the credentialed actuarial owner of those commitments from first design through final settlement.

As Director, Actuarial & Performance Guarantees, you’ll help shape Twin’s deals from the start, validating the business case we present to clients. You’ll lead the development of Twin’s performance guarantees and serve as the actuarial voice in partner contracting. You’ll also oversee measurement and settlement of every guarantee in market. You’ll partner closely with Accounting and Finance to ensure the company forecasts guarantee outcomes accurately and recognizes revenue appropriately.

This is a highly visible role reporting into Value, Access & Pricing leadership, working directly with senior leadership, sales, finance, clinical, and data teams. Your work will shape how health plans, employers, and health systems evaluate Twin.

• Shape deals from the start by partnering with sales and pricing on deal structure, fees at risk, and guarantee terms, so that each opportunity is commercially attractive and actuarially sound before it reaches contracting, including structuring arrangements that fit Medicare Advantage plan economics, bid cycles, and quality programs.
• Validate client business cases by reviewing the savings projections, ROI models, and population assumptions Twin presents to prospective clients. You’ll make sure every claim is defensible and consistent with how Twin measures and guarantees results.
• Lead performance guarantee design, including savings and clinical guarantee structures, measurement windows, comparison populations, statistical credibility thresholds, and payout mechanics. You’ll balance what partners find compelling against the risk Twin can responsibly hold.
• Price guarantee risk by modeling expected payout distributions and fees at risk under a range of…