FHA Sr. Underwriter – LEAN

KeyBank • Columbus, OH

2d • $96,000 - $181,000 • Hybrid

About The Position

As an FHA Senior Underwriter – LEAN, you will lead the underwriting and execution of complex FHA-insured healthcare transactions under HUD's Section 232 Program, including 232/223(f) acquisitions and refinances, and 223(a)(7) refinances. Eligible property types include skilled nursing facilities, assisted living facilities, memory care communities, intermediate care facilities, and board and care homes. This role is responsible for driving transactions from engagement letter through firm commitment, serving as the lead underwriting authority and primary liaison with HUD's Office of Residential Care Facilities (ORCF). You will partner closely with originators and credit leadership to underwrite and structure deals, assess risk, and deliver high-quality, compliant submissions. This role is critical to supporting the growth and performance of KeyBank's FHA healthcare lending platform. Please note: We have a strong preference for candidates to be based in one of KeyBank’s regional office locations to support collaboration and team integration.

Requirements

• Minimum of five (5) years of direct experience underwriting FHA-insured healthcare loans under HUD's Section 232 Program.
• Current LEAN-certified Underwriter designation from HUD that is in good standing.
• Demonstrated expertise in analyzing healthcare real estate transactions—including skilled nursing, assisted living, memory care, and board and care facilities—with strong knowledge of FHA underwriting fundamentals and the Section 232 Handbook.
• Proven experience preparing and reviewing HUD-required loan documentation, including underwriting narratives, credit memos, HUD forms, and firm commitment applications specific to the LEAN process.
• Proficiency in financial modeling and advanced Excel-based analysis for healthcare real estate underwriting, including operator financial analysis and debt service coverage evaluation.
• Experience reviewing and interpreting third-party reports, including appraisals, market studies, environmental reports (Phase I/II), and Property Capital Needs Assessments (PCNAs).
• Excellent verbal and written communication skills, with the ability to convey complex underwriting concepts clearly and professionally.
• Bachelor's degree required.

Nice To Haves

• A degree in Real Estate, Finance, Healthcare Administration, or Accounting is preferred; however, candidates with degrees in other relevant fields will be considered based on experience and qualifications.
• LEAN designation.
• Experience underwriting LEAN new construction and/or substantial rehabilitation transactions under Section 232.
• Familiarity with Medicare/Medicaid reimbursement structures, state licensing requirements, and healthcare regulatory environments.
• Prior experience managing or mentoring junior underwriters or analysts.

Responsibilities

• Perform due diligence for proposed FHA-insured healthcare loans, including analyzing proposed transactions, reviewing third-party reports (appraisals, market studies, environmental assessments, Property Capital Needs Assessments), and leading the underwriting team to prepare loan applications for electronic submission to HUD via the LEAN application portal.
• Underwrite and analyze single loans or be part of a team on large portfolios of loans eligible under the LEAN program, including detailed review of all third-party reports and preparation of written narratives that identify the strengths and weaknesses of each transaction, along with appropriate risk mitigation strategies.
• Conduct healthcare operator analysis, including review of facility-level financial statements, historical occupancy trends, Medicare/Medicaid reimbursement data, state licensing and survey history, and management capability.
• Serve, as needed, as the lead underwriting authority on asset management–related transactions, including Change of Ownership/Operator (CHOPs), Change of Ownership (CHOWs), and other Transfer of Physical Assets (TPAs), providing oversight on underwriting approach, risk assessment, and submission strategy to HUD.
• In addition, lead Corporate Credit Reviews on an annual basis, or more frequently as required by HUD or internal policy, including oversight of underwriting analysis, portfolio risk evaluation, and coordination across large or complex portfolios to ensure consistency, accuracy, and compliance with regulatory expectations.
• Complete, review, and ensure accuracy of all required HUD-form documents for LEAN application submissions in compliance with the Section 232 Handbook.
• Build and analyze financial models to evaluate loan feasibility, cash flow projections, debt service coverage, and risk scenarios specific to healthcare properties.
• Drive all assigned transactions through the underwriting pipeline to ensure timely and accurate completion from application through firm commitment.
• Identify and assess transaction risks—including credit, project, and operational flaws—document findings in accordance with credit approval requirements, provide risk mitigation for weaknesses, and escalate deviations to support effective portfolio risk management.
• Provide detailed peer reviews of LEAN application packages for other underwriters in advance of KeyBank's loan committee.
• Maintain productive relationships with all partners, including mortgage bankers, borrowers, healthcare operators, HUD/ORCF staff, and third-party consultants—through a collaborative approach and timely disclosure of transaction risks.
• Maintain a strong working knowledge of the Section 232 Handbook, relevant Housing Notices, Mortgagee Letters, HUD email blasts, and all applicable program guidance.
• Actively contribute market intelligence, healthcare industry insights, and programmatic expertise in support of the team's strategy and financial goals.
• Pursue and develop internal and external relationships to facilitate effective healthcare real estate transactions and support the line of business strategy.
• Complete all compliance requirements related to each transaction to minimize risk.
• Deliver responsive, exceptional customer service throughout all stages of the transaction process.
• Collaborate with mortgage bankers and management to support the origination of FHA healthcare loans and drive new business opportunities.
• Facilitate staff development by conducting training sessions, identifying growth opportunities, and promoting continuous learning for both team members and self.
• Lead recruitment and onboarding efforts to ensure seamless integration of new hires into the team.
• Assist in maintaining and improving underwriting models, forms, and systems used for LEAN submissions.
• Represent KeyBank with professionalism and excellence at industry conferences, HUD training sessions, ORCF meetings, and trade organization events.
• Travel as required, including overnight stays, to conduct property/site inspections and fulfill other job-related duties.

Benefits

• base salary in the range of $96,000.00 - $181,000.00 annually
• eligibility for incentive compensation which may include production, commission, and/or discretionary incentives
• list of benefits for which this position is eligible

What This Job Offers

• Job Type: Full-time
• Career Level: Senior