Senior Accounting Manager

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.

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.

We are seeking a highly motivated and experienced Senior Accounting Manager to manage our core accounting operations and support our financial growth as a scaling private health tech company. In this role, you will be the backbone of our daily accounting functions, ensuring accuracy, compliance, and efficiency across the general ledger and accounting operations.

You will supervise the month-end close process, manage critical financial systems, and lead a high-performing accounting team. Success in this role requires a roll-up-your-sleeves mentality, deep expertise in ERP administration, and a strategic mindset to build scalable accounting processes that can mature alongside our fast-growing business.

• →Month-End Close & GL Management: Lead the day-to-day general ledger accounting and manage the end-to-end month-end, quarter-end, and year-end close processes, ensuring timeliness and accuracy in accordance with US GAAP.
• →Team Leadership: Supervise, mentor, and develop a high-performing accounting team, fostering a culture of continuous improvement and professional growth.
• →ERP Expertise & Administration: Serve as the primary administrator and subject matter expert for our ERP systems, optimizing workflows, managing integrations, and ensuring data integrity.
• →Cash Flow Management: Partner with the broader finance team to monitor daily cash flow, assist in preparing cash flow forecasts, and optimize working capital to support the company's operational needs and financial health.
• →Accounts Payable & Expense Management: Oversee the accounts payable function and employee expense reporting processes, ensuring timely payments, accurate coding, and adherence to company policies.
• →Payroll & Benefits Accounting: Manage the accounting for payroll, commissions, and employee benefits, partnering closely with the HR and People teams to ensure accurate recording and reconciliation.
• →Process Improvement & Controls: Design, implement, and maintain scalable accounting policies, procedures, and internal controls suitable for a fast-changing environment.
• →Audit Support: Act as a key liaison for external auditors, preparing schedules, providing documentation, and addressing inquiries during annual audits.

• 7+ years of progressive accounting experience, ideally with a mix of public accounting and in-house experience. Experience at a pre-IPO and/or high-growth tech or health tech company is a plus.
• Active CPA license is strongly preferred.
• Deep expertise in month-end close processes and day-to-day general ledger accounting.
• Proven experience supervising and developing accounting staff.
• Strong hands-on experience with top-tier ERP systems (e.g., NetSuite), including system administration and optimization. System implementation experience is a plus.
• Comprehensive knowledge of accounts payable, expense management, and payroll/benefits accounting.
• Experience with inventory accounting and supply chain financial operations is a plus.
• Exceptional analytical, organizational, and problem-solving skills with a keen eye for detail.
• Excellent written and verbal communication skills, with the ability to explain complex accounting concepts to non-financial stakeholders.
• This opportunity is available to those who are able to work a hybrid remote/in-office schedule. On-site attendance at our Midtown NYC office 2-3 days/week is preferred, but flexible. Applicants must be authorized to work for any employer in the U.S. We are unable to sponsor or take over sponsorship of an employment Visa at this time.