Medical Underwriting Manager jobs

Role Summary

The Underwriting Review & Assurance Lead is responsible for designing, implementing, and delivering Rokstone’s underwriting review and assurance framework and overall audit management process. Reporting to the Head of Underwriting Excellence & Governance, the role leads the development of peer review processes, underwriting file reviews, and assurance activity to improve underwriting and file quality, decision consistency, and compliance with underwriting standards. The role also has complete oversight and management of the end-to-end audit process across Rokstone. The role provides independent insight into underwriting practices, identifies themes and control opportunities, and supports continuous improvement across Rokstone’s underwriting platform. The role ensures that underwriting is compliant, consistent, well-governed, and aligned with underwriting appetite, regulatory obligations, and underwriting strategy.

Role Accountabilities

• Support in the design, implementation and continuous enhancement of Rokstone's audit, underwriting peer review and assurance framework and overall Rokstone audit process
• Deliver independent underwriting reviews across products, portfolios and territories, assessing compliance with underwriting standards, delegated authorities, underwriting appetite and governance requirements.
• Identify control weaknesses, emerging risks, recurring themes and opportunities to improve underwriting quality, consistency and decision-making.
• Conducting root cause analysis of recurring findings and identifying systemic improvements across underwriting processes, training, controls and technology
• Drive remediation by tracking actions arising from all audit and assurance reviews and supporting the embedding of sustainable improvements across the underwriting function.
• Lead the coordination and facilitation of internal and external underwriting audits, acting as the primary liaison between auditors and the business.
• Manage the end-to-end audit lifecycle, including planning, stakeholder engagement, evidence gathering, issue management and timely delivery of audit responses.
• Monitor, challenge and report on progress against audit and assurance actions, ensuring findings are effectively remediated and closed.
• Produce and present high-quality management information and reporting on assurance outcomes, audit findings, trends, key risks and remediation progress for senior management and relevant governance committees.
• Partner with Underwriting, Portfolio Optimisation, IT, Risk, Compliance and Operations to strengthen underwriting controls, governance and operating standards.
• Support the development and continuous improvement of underwriting policies, standards, review methodologies and governance processes.
• Promote a culture of constructive challenge, accountability and continuous improvement by building strong relationships across the underwriting community.
• Provide feedback and insight to support underwriter development, technical training and capability improvement initiatives.
• Support the embedding of assurance findings into underwriting controls, governance processes and technology solutions, including the ATOMX ecosystem, to enhance efficiency, consistency and control.

Role Requirements

• Experience in underwriting, underwriting governance, quality assurance, audit, or technical underwriting within insurance or an MGA environment.
• Strong understanding of underwriting processes, delegated authority, and underwriting controls.
• Experience conducting file reviews, assurance testing, or technical audits.
• Knowledge of specialty insurance products and underwriting governance expectations.
• Ability to work credibly with underwriters and senior stakeholders.

Skills & Abilities

• Strong understanding of underwriting principles, standards, and controls.
• Ability to identify themes, trends, and areas for improvement from assurance activity.
• Comfortable providing objective challenge while maintaining strong stakeholder relationships.
• High level of accuracy and rigour in review activity and reporting.
• Clear and confident communicator, able to deliver findings effectively.
• Ability to influence and engage underwriting teams positively.
• Proactive in identifying opportunities to improve quality and consistency.
• Comfortable operating in a fast-paced, evolving underwriting environment.
• Excellent planning and organisational skills, with the ability to coordinate multiple audits and assurance activities simultaneously.
• Strong analytical and reporting skills, able to distil complex findings into clear executive-level insight.
• Ability to manage competing stakeholder priorities while maintaining independence and objectivity.
• Strong project management skills with disciplined follow-through on actions and remediation.
• Confident facilitating discussions with auditors, underwriters and senior leadership.

Management Duties

• No (with potential to support or mentor junior team members as the function grows)

We are an equal opportunity employer, and we are proud to share that 93% of our employees say they can be themselves at work. We aim to hire our industry's finest people because the best people drive the best outcomes.

And we forever challenge the status quo because we know there are always ways to improve things. Because together, we're limitless. We value applicants from all backgrounds and foster a culture of inclusivity. We understand the need for flexibility, so work in a hybrid model. Please let us know if you require any reasonable adjustments during the recruitment process.