Lead Director, Underwriting - Stop Loss & Claim Strategy

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.

Support Aetna's ability to achieve its financial and strategic goals through

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.

• 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.

• 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.

• 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.

• 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.

• 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.

• 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.

• Bachelor’s degree required or equivalent experience.

• Degree in Mathematics, Economics, Accounting, or a related field strongly preferred.

The typical pay range for this role is:

$ - $

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.

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