Senior Medical Underwriting Nurse Manager - Remote

Overview

The Sr. Medical Underwriting Nurse Manager is responsible for leading clinical risk strategy and underwriting excellence within the Small Group market, reporting to the VP of Small Group Underwriting. This role combines advanced clinical expertise with underwriting leadership to drive profitable risk selection, guide pricing strategy, and support renewal and new business growth.

In Short

• Contributes to the development of underwriting guidelines for clinical underwriting risk management.
• Guides underwriting strategy in collaboration with VP of Small Group Underwriting.
• Provides expert clinical consulting on underwriting risk initiatives.
• Manages direct reports and relationships with key stakeholders.
• Formulates and executes strategy to meet key target metrics.
• Responsible for a book of business of renewing accounts and writing new business.
• Evaluates eligibility of groups and participating employees.
• Calculates rates and interprets pricing policy.
• Identifies questionable claim patterns and develops recommendations.
• Communicates recommendations of policy adaptation to accommodate client-specific situations.

Requirements

• Registered Nurse, BSN.
• 5 Years of Medical Underwriting Experience.
• Advanced clinical knowledge of high-risk diagnoses and treatment plans.
• Expert knowledge of claims for common and high-risk diagnoses.
• MSN/MBA preferred.
• Experience in Small Group Health Insurance Medical Underwriting.

Benefits

• Competitive compensation.
• Comprehensive health coverage (medical, dental, vision).
• Employer-paid life insurance and disability coverage.
• 401(k) retirement plan with employer match.
• Generous paid time off and company holidays.