Senior Manager, Medical Underwriter

Medical Underwriting Lead

We're building a world of health around every individual – shaping a more connected, convenient and compassionate health experience. At CVS Health®, you'll be surrounded by passionate colleagues who care deeply, innovate with purpose, hold ourselves accountable and prioritize safety and quality in everything we do. Join us and be part of something bigger – helping to simplify health care one person, one family and one community at a time.

A Brief Overview

Leads medical underwriting strategy and execution within Aetna's Supplemental Health Large Group division, managing risk evaluation and financial performance for the MedPremier/Boon fully insured medical product portfolio. Directs a small team of underwriters responsible for new business quoting, renewal management, and broker engagement across large group accounts. Ensures rate adequacy and loss ratio performance align with divisional financial targets while delivering competitive, broker-ready proposals. Partners closely with actuarial leadership on pricing governance and escalated case approvals within a tiered underwriting authority framework.

What You Will Do

• Directs medical underwriting operations for the MedPremier/Boon medical book, setting case-level standards for new business evaluation, renewal rate actions, and exception management consistent with divisional pricing governance.

• Evaluates large group medical RFPs end-to-end: census and plan design review, actuarial rate alignment, competitive positioning, and final proposal packaging for brokers and consultants.

• Manages annual renewal cycle for the assigned medical book – experience pulls, loss ratio analysis, rate action recommendations, and broker negotiation – with proactive intervention on accounts running above target loss ratios.

• Partners with the Actuarial team to align filed rates with emerging experience, escalate cases outside delegated authority, and support WD5 financial close reporting on earned premium and incurred claims.

• Approves medical underwriting exceptions and financial variances within delegated authority; escalates cases to the Lead Director and VP Supplemental Health per premium-tier thresholds.

• Leads broker and consultant-facing engagements, including BAFO presentations, experience reviews, and renewal negotiations – representing Aetna's underwriting rationale with clarity and credibility.

• Collaborates cross-functionally with Sales, Enrollment Operations, Commissions, and Compliance to support plan implementations, QLE administration, and regulatory requirements unique to the FI medical segment.

• Manages team performance, workflow prioritization, and development for two direct reports, balancing turnaround SLAs against case complexity and account ownership.

For This Role You Will Need – Minimum Requirements

• 5+ years of large group medical underwriting experience, including full-cycle responsibility for both new business and renewals

• Demonstrated fluency in medical underwriting financials: loss ratios, PMPM trends, IBNR /completion factors, credibility, and rate adequacy analysis

• Experience managing broker/consultant relationships in a competitive, multi-carrier environment

• Proficiency with group medical rating tools and UW case management platforms

• Strong written communication skills for executive-ready memos, broker-facing proposals, and escalation summaries

• Adept at execution and delivery – managing competing priorities and turnaround deadlines in a high-volume environment

• Mastery of problem solving and decision-making under uncertainty, with comfort operating within a delegated authority framework

Education

• Bachelor's degree required; concentration in mathematics, finance, actuarial science, or business preferred

• Relevant professional qualification (ALHC, FLHC) a plus

Pay Range

The typical pay range for this role is:

$67,900.00 – $182,549.00

This pay range represents the base hourly rate or base annual full-time salary for all positions in the job grade within which this position falls. The actual base salary offer will depend on a variety of factors including experience, education, geography and other relevant factors. This position is eligible for a CVS Health bonus, commission or short-term incentive program in addition to the base pay range listed above. This position also includes an award target in the company's equity award program.

Our people fuel our future. Our teams reflect the customers, patients, members and communities we serve and we are committed to fostering a workplace where every colleague feels valued and that they belong.

Great benefits for great people

We take pride in offering a comprehensive and competitive mix of pay and benefits that reflects our commitment to our colleagues and their families.

This full-time position is eligible for a comprehensive benefits package designed to support the physical, emotional, and financial well-being of colleagues and their families. The benefits for this position include medical, dental, and vision coverage, paid time off, retirement savings options, wellness programs, and other resources, based on eligibility.

Additional details about available benefits are provided during the application process and on Benefits Moments.

We anticipate the application window for this opening will close on: 07/31/2026

Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state and local laws.

CVS Health is an equal opportunity/affirmative action employer, including Disability/Protected Veteran – committed to diversity in the workplace.