Director Underwriter-Healthcare/CRE (hybrid)

This is a hybrid role with the expectation that time working will regularly take place inside and outside of a company office.

First Citizens Healthcare Finance provides comprehensive financing and banking solutions to middle market healthcare companies across the U.S. Using a client-focused and industry-centric model, Healthcare Finance can tailor its products and services to help clients meet their needs for growth capital.

This role combines leadership with hands-on execution, supporting both new loan originations and ongoing portfolio management. The Director will underwrite and close stabilized and construction loan transactions, while also preparing to lead and develop a team of junior analysts and associates. This position plays a critical role in balancing revenue generation with sound risk management practices across the healthcare real estate portfolio.

Key Responsibilities

Leadership & Oversight

• Provide strategic direction and oversight to Healthcare Underwriting and Portfolio Management teams
• Ensure adherence to underwriting standards, credit policies, and service level agreements
• Make informed decisions on complex credit structures and loan approvals
• Transition into management of 3+ junior analysts/associates, providing mentorship and performance guidance

Underwriting & Deal Execution

• Lead underwriting and closing of new loan originations, including stabilized and construction financing
• Structure credit facilities to align with risk tolerance and return objectives
• Partner with originators, credit teams, and senior leadership to advance transactions

Portfolio Management

• Support ongoing portfolio monitoring, analysis, and reporting
• Address portfolio needs and identify opportunities for optimization
• Ensure risk is properly assessed and managed across the healthcare real estate portfolio

Collaboration & Communication

• Serve as a key liaison between originators, credit partners, leadership, and clients
• Operate effectively in a fast-paced, team-oriented environment
• Deliver clear, concise analysis and recommendations for decision-making

Required

• Bachelor's degree with 8+ years of experience in credit analysis, underwriting, or risk management
  OR
• High school diploma/GED with 12+ years of relevant experience

Preferred

• Master's degree
• Formal bank credit training
• Prior experience managing junior team members
• Strong background in commercial real estate lending, including construction financing
• Experience underwriting healthcare real estate assets (e.g., MOBs, inpatient rehab, senior housing)
• 7 years in CRE finance with a focus on credit underwriting
• Advanced analytical, financial modeling, and communication skills
• Proficiency in Microsoft Excel and experience with Argus

The base pay for this position is generally between $180,000.00 and $225,000.00. Actual starting base pay will be determined based on skills, experience, location, and other non-discriminatory factors permitted by law. For some roles, total compensation may also include variable incentives, bonuses, benefits, and/or other awards as outlined in the offer of employment.

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Benefits are an integral part of total rewards and First Citizens Bank is committed to providing a competitive, thoughtfully designed and quality benefits program to meet the needs of our associates. More information can be found at