A&H Underwriting

Job Description

About the Role

We are seeking an experienced underwriting and health risk management professional to lead underwriting governance, portfolio management, product risk assessment, and process optimization initiatives. The role requires strong expertise in health insurance underwriting, risk management, regulatory compliance, product development support, claims analytics, and stakeholder management. The incumbent will play a key role in driving underwriting excellence, enhancing risk frameworks, supporting product innovation, and ensuring sustainable portfolio profitability.

Key Responsibilities

Underwriting & Risk Management

• Develop, implement, and maintain underwriting guidelines, risk acceptance frameworks, and underwriting governance standards.
• Evaluate complex medical and non-medical risks across retail and group health insurance portfolios.
• Monitor underwriting quality, risk selection practices, and portfolio performance to ensure alignment with organizational objectives.
• Conduct underwriting audits and quality reviews to identify process gaps and recommend corrective actions.
• Drive continuous improvement in underwriting efficiency, consistency, and decision-making.

Portfolio Management

• Monitor portfolio performance through regular analysis of loss ratios, claims trends, underwriting outcomes, and risk indicators.
• Recommend strategic actions to improve portfolio profitability and risk management.
• Support portfolio reviews and contribute to business planning initiatives.
• Manage renewals and ongoing portfolio optimization efforts.

Product Development & Risk Assessment

• Collaborate with product, actuarial, claims, and business teams during product development and enhancement initiatives.
• Assess underwriting implications, product risks, and policy conditions for new and existing products.
• Participate in product design reviews, UAT activities, and implementation of underwriting rules.
• Analyze emerging risk trends and provide recommendations for product enhancements.

Claims & Fraud Analytics

• Review claims trends and conduct audits to identify fraud risks, benefit leakage, and process inefficiencies.
• Work closely with claims teams to strengthen risk controls and improve claims outcomes.
• Support investigations and root cause analysis of adverse claims experience.

Regulatory Compliance & Governance

• Ensure compliance with regulatory requirements, underwriting policies, and internal governance standards.
• Maintain documentation of underwriting decisions, risk framework updates, and policy changes.
• Support regulatory reviews, audits, and compliance initiatives.
• Assist in the implementation of risk management policies and governance controls.

Digital Transformation & Process Improvement

• Lead and support underwriting automation, digitization, and workflow optimization initiatives.
• Collaborate with technology teams on system enhancements, underwriting engines, and rule-based decision frameworks.
• Participate in the development and implementation of AI-driven underwriting and risk management solutions.
• Drive operational excellence through process redesign and technology adoption.

Stakeholder Management

• Collaborate with internal stakeholders including underwriting, claims, actuarial, product, operations, sales, and technology teams.
• Build strong relationships with external partners, medical experts, service providers, and other stakeholders.
• Provide underwriting expertise and guidance to support business growth initiatives.

Leadership & Training

• Mentor and develop underwriting professionals through coaching, training, and knowledge-sharing initiatives.
• Conduct workshops and training programs on underwriting practices, risk management, and regulatory requirements.
• Promote a culture of continuous learning, accountability, and operational excellence.

Desired Candidate Profile

Experience

• 8–15 years of experience in health insurance underwriting, risk management, claims analytics, or related functions.
• Experience in retail and group health insurance underwriting preferred.
• Exposure to product development, underwriting governance, and portfolio management is highly desirable.
• Experience leading audits, process improvement initiatives, and cross-functional projects.

Education

• Graduate degree in Medicine, Healthcare, Insurance, Risk Management, Statistics, or a related discipline.
• A postgraduate qualification or a Doctorate in a relevant field will be an added advantage.

Skills & Competencies

• Strong understanding of health insurance underwriting principles and risk assessment.
• Knowledge of claims analysis, fraud detection, and portfolio management.
• Familiarity with regulatory and compliance requirements within the insurance sector.
• Excellent analytical, problem-solving, and decision-making skills.
• Experience with underwriting systems, automation initiatives, and digital transformation projects.
• Strong communication, stakeholder management, and leadership capabilities.

Key Success Indicators

• Improved underwriting quality and risk selection.
• Enhanced portfolio profitability and risk management outcomes.
• Successful implementation of automation and process optimization initiatives.
• Strong regulatory compliance and governance standards.
• Effective collaboration across business functions and stakeholders.
• Continuous development of underwriting capabilities and team performance.