FHA Sr. Underwriter – LEAN

About the role

KeyBank Real Estate Capital is one of the nation's leading commercial real estate finance platforms, offering a full range of debt and equity solutions across multiple property types. Our Commercial Mortgage Group (CMG) is a top-tier FHA lender with a proven track record of originating and servicing FHA-insured healthcare loans under HUD's Section 232 Program. We are committed to delivering exceptional client service while maintaining a disciplined, risk-conscious approach to every transaction.

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.
• 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.
• Deliver responsive, exceptional customer service throughout all stages of the transaction process.

Qualifications

• 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. 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.

Skills

• Strong organizational and time management skills, ensuring tasks are completed efficiently under tight deadlines.
• Initiative, sound judgment, and the ability to work independently with minimal supervision.
• Manage multiple complex transactions simultaneously while maintaining high standards of quality and accuracy.
• Thrive in collaborative, team-oriented environments, fostering cooperation and shared success.
• Resolve conflicts constructively and professionally, maintaining a calm and solution-focused approach.
• Demonstrate strong attention to detail and commitment to accuracy in all underwriting work product.

Equipment Used / Physical Requirements

• Proficient in PC-based productivity tools including Microsoft Word, Excel, Outlook, and Adobe Acrobat, with the ability to leverage these platforms for efficient documentation, analysis, and communication.
• Skilled in utilizing financial calculators and Excel-based financial modeling tools to perform advanced underwriting, scenario analysis, and data-driven decision-making.

Compensation and Benefits

This position is eligible to earn a base salary in the range of $96,000.00 - $181,000.00 annually. Placement within the pay range may differ based upon various factors, including but not limited to skills, experience and geographic location. Compensation for this role also includes eligibility for incentive compensation which may include production, commission, and/or discretionary incentives. Please click here for a list of benefits for which this position is eligible.