Director, Actuarial & Performance Guarantees

Twin Health • New York, NY

2d • $205,000 - $215,000 • Remote

About The Position

Twin Health is hiring a Director, Actuarial & Performance Guarantees to own the actuarial design, pricing, contracting, measurement, and settlement of the company’s performance guarantees. The role shapes client deals from the outset, validates projected savings and return on investment, and develops defensible savings and clinical guarantee structures that balance partner needs with Twin’s risk exposure.

The Director serves as Twin’s actuarial lead in partner contracting and oversees guarantee execution from data inputs through reconciliation, settlement, and dispute resolution. In partnership with Accounting and Finance, the role forecasts expected guarantee payouts, supports accruals and true-ups, and helps ensure revenue is recognized appropriately under ASC 606. The Director also governs actuarial methods and documentation, collaborates with sales, clinical, and data engineering teams, and builds the actuarial function as Twin’s guaranteed business grows.

This highly visible remote opportunity is based in the U.S. and reports into Value, Access & Pricing leadership. The role works directly with senior leadership and teams across sales, finance, clinical, and data. Applicants must be authorized to work for any U.S. employer; visa sponsorship is not available. Compensation is $205,000–$215,000 annually, with bonus eligibility.

Requirements

• Fellow of the Society of Actuaries (FSA) and Member of the American Academy of Actuaries (MAAA).
• At least 8 years of health actuarial experience.
• At least 3 years designing, pricing, or reconciling performance guarantees, value-based contracts, or vendor ROI arrangements at a payer, consulting firm, or health services company.
• Direct Medicare Advantage actuarial experience, including working knowledge of the MA bid process, CMS-HCC risk adjustment, Star Ratings, medical loss ratio requirements, supplemental benefits, and how vendor programs affect plans.
• Experience shaping deal structures and negotiating actuarial terms directly with health plans, employers, or their consultants, and defending business cases and methodology under external review.
• Experience partnering with Accounting on revenue recognition, accruals, or reserving for at-risk or contingent arrangements.
• Strong grounding in claims-based savings measurement, risk adjustment, and comparison group methods, including difference-in-differences and matched cohort designs, and understanding of their limitations.
• Advanced SQL skills and proficiency in R or Python, with comfort working directly in a modern data warehouse.
• Ability to communicate complex actuarial findings as clear recommendations to senior leaders, sales teams, and external partners.
• Applicants must be authorized to work for any employer in the U.S.; Twin Health is unable to sponsor or take over sponsorship of an employment visa.

Nice To Haves

• Familiarity with ASC 606 variable consideration.

Responsibilities

• Partner with sales and pricing on deal structure, fees at risk, and guarantee terms, including arrangements suited to Medicare Advantage plan economics, bid cycles, and quality programs.
• Review client savings projections, ROI models, and population assumptions to ensure claims are defensible and consistent with Twin’s measurement and guarantee methods.
• Design savings and clinical performance guarantees, including measurement windows, comparison populations, statistical credibility thresholds, and payout mechanics.
• Model expected payout distributions and fees at risk under different scenarios, linking guarantee terms to Twin’s pricing and deal structures.
• Lead actuarial work in contracting, including owning guarantee terms in negotiations, reviewing contract language, and defending methodologies with payer actuaries, benefits consultants, and partner analytics teams.
• Oversee guarantee execution from data inputs through measurement, reconciliation, settlement, and resolution of partner disputes, ensuring results are reproducible and defensible.
• Partner with Accounting and Finance to estimate expected payouts for variable consideration under ASC 606, support quarterly accruals and true-ups, and ensure revenue forecasts reflect realistic guarantee performance.
• Document and validate savings and outcome methods, produce actuarial memos consistent with relevant Actuarial Standards of Practice, and maintain an audit trail for each guarantee.
• Work with sales, clinical, and data engineering teams to ensure guarantee definitions are operational, measurable, and supported by Twin’s claims data model.
• Establish actuarial processes, mentor analysts, and help shape the growth of the actuarial team.
• Perform other duties as assigned.

Benefits

• Bonus eligibility.
• Opportunity for equity participation.
• Unlimited vacation with manager approval.
• 16 weeks of 100% paid parental leave for delivering parents and 8 weeks for non-delivering parents.
• 100% employer-sponsored health, dental, and vision coverage for employees, with 80% coverage for family members.
• Health Savings Account and Flexible Spending Account options.
• 401(k) retirement savings plan.
• Remote work and a flexible employee experience.

What This Job Offers

• Job Type: Full-time
• Career Level: Director
• Education Level: No Education Listed