The Sr. Medical Underwriting Nurse Manager is responsible for leading clinical risk strategy and underwriting excellence within the Small Group market, reporting to the VP of Small Group Underwriting. This role combines advanced clinical expertise with underwriting leadership to drive profitable risk selection, guide pricing strategy, and support renewal and new business growth. Contributes to the development of underwriting guidelines for clinical underwriting risk management Guides underwriting strategy in collaboration with VP of Small Group Underwriting and internal stakeholders for targeted profitable risk selection Provides expert clinical consulting on underwriting risk initiatives in collaboration with Actuarial Partners, Sales, IT, Underwriters, and Compliance Manages direct reports and relationships with key stakeholders as delegated with mentorship and clinical consultations as needed Helps formulate and execute strategy of how to hit or exceed key target metrics such as loss ratio, underwriting expense, close ratio, and underwriting turnaround times Develops and manages relationships with internal business partners, including actuarial, sales, IT, and compliance Responsible for a book of business of renewing accounts and writing new business at profitable levels Uses various systems, tools, and resources to obtain necessary data and accurately complete and track assigned work Evaluates the eligibility of groups and the participating employees at the time of a new business quote Calculates rates, evaluates different financial arrangements, interprets pricing policy, and adapts to unusual situations Identifies questionable claim patterns of renewal clients and evaluates competitors’ claims experience for prospective clients Applies corporate risk management policies and adjusts for unusual situations Enforces Optimyl's business rules (participation, product availability, etc.) Analyzes individual member risk and aggregates to the total group Supports other internal initiatives including underwriting policies and procedures, training, fraud detection, corporate compliance, and product development efforts Completes renewals, prospective quotes, and review of lower-level analyst work in accordance with production and timeliness standards Adapts to changing priorities as quotes come in from different markets Communicates recommendations of policy adaptation to accommodate client-specific situations Serves as a clinical SME to sales and account management Guides, assists, and provides technical assistance to lower-level analysts