Lead Director, Underwriting - Stop Loss & Large Claim Strategy

This role provides strategic leadership over medical underwriting and risk assessment for high‑cost claimants, with a focus on protecting profitability while supporting membership growth and revenue objectives. The position oversees Large Claim Support functions, including identification, evaluation, and management of high‑risk cases across a diverse book of business.

Key Responsibilities

Strategic Leadership & Oversight

• Lead and direct managers and multi‑functional clinical underwriting teams responsible for complex, high‑profile new business and renewal underwriting decisions.
• Oversee core Stop Loss Center of Excellence (COE) functions, including audits, tools, underwriting strategy, training, and continuous process improvement.
• Own reconciliation processes and provide oversight of the Cognizant support team to ensure accuracy, consistency, and operational efficiency.
• Anticipate and proactively address issues that materially impact financial performance, applying sound, unbiased decision‑making.

Underwriting & Risk Management

• Oversee a broad book of business spanning all market segments and funding arrangements, including large claimant underwriting for Aetna Signature Administrators.
• Guide teams in the evaluation and management of high‑cost claimant risk to optimize earnings and client outcomes.
• Support underwriting teams in resolving complex or escalated risk assessments.

People Leadership & Talent Development

• Lead multiple managers and professional teams to achieve Stop Loss COE goals through clear articulation of business strategy and underwriting best practices.
• Identify staffing needs and drive talent management activities, including hiring, performance management, succession planning, training, and professional development.
• Serve as a coach and mentor to managers and senior underwriters.

Collaboration & Influence

• Build and maintain strong cross‑functional partnerships with Sales, Account Management, and other internal stakeholders.
• Represent the organization on internal work groups and external forums, acting as a subject‑matter expert and thought leader.
• Effectively negotiate and resolve conflicts using clear, impactful oral and written communication.

Qualifications

Required

• Bachelor’s degree or equivalent work experience.
• 10+ years of financial underwriting experience, including deep expertise in high‑cost claimant risk.
• 10+ years of Stop Loss and/or medical underwriting experience.
• Demonstrated experience leading managers, individual contributors, and larger teams.
• Proven leadership capability with strong cross‑functional partnership skills.

Preferred

• Advanced knowledge of high‑cost claimant management and Stop Loss product strategy.
• Broad understanding of other benefit programs (medical, dental, vision, pharmacy, Medicare, voluntary benefits) and their impact on risk assessment.

Education

• Bachelor’s degree required or equivalent experience.
• Degree in Mathematics, Economics, Accounting, or a related field strongly preferred.