A hooded gunman who was lying in wait for UnitedHealthcare CEO Brian Thompson shot and killed the executive outside a Manhattan hotel Wednesday in what police say appeared to be a "brazen, targeted attack.''

Thompson, 50, was fatally wounded outside the Midtown Hilton and video evidence indicated the gunman waited about five minutes, as many others walked past, before approaching his victim from behind and firing several rounds, Jessica Tisch, New York City police commissioner, said at a news conference.

The executive, who was walking to the annual investor conference for Minnetonka-based parent company UnitedHealth Group, was struck at least once in the back and at least once in the leg, Tisch said.

"Brian Thompson, the CEO of UnitedHealthcare, was shot and killed in what appears — in this early stage of our investigation — to be a brazen, targeted attack," Tisch said. "This does not appear to be a random act of violence."

The commissioner added: "I want to be clear, at this time, every indication is that this was a premeditated, pre-planned, targeted attack."

The gunman remained at large as of Wednesday night. Police are offering a $10,000 reward for information on the attack. The shooting occurred about 6:45 a.m. Eastern time.

Thompson, who lived in Maple Grove, had arrived in New York on Monday and was walking alone to the investor conference without a security detail, Chief of Detectives Joseph Kenny said during the news conference.

Video shows the shooter step out from behind a car and ignore other pedestrians before firing on Thompson from behind, Kenny said. The assailant then walked toward Thompson and continued to shoot, until the gun apparently malfunctioned.

After clearing the jam, the shooter began to fire again, Kenny said, and then fled on foot.

Responding to reporters, Kenny said police don't know if the shooter could have been a professional, nor could investigators say if there was a silencer on the weapon. From watching the video, he said, "it does seem that he's proficient in the use of firearms as he was able to clear the malfunctions pretty quickly."

After his initial flight from the scene, the suspect was later seen riding an e-bike, including when he was spotted in Central Park.

"The motive for this murder currently is unknown," Kenny said. "Based on the evidence we have so far, it does appear that the victim was specifically targeted. But at this point, we do not know why."

UnitedHealthcare is the nation's largest health insurer. It is a division of UnitedHealth Group, the fourth-largest public company in America behind Walmart, Amazon and Apple.

Thompson's wife, Paulette Thompson, told NBC News that he had been receiving threats. "There had been some threats," she said in a phone call. "Basically, I don't know, a lack of coverage? I don't know details. I just know that he said there were some people that had been threatening him."

During the police news conference, reporters asked Kenny if there was any evidence to suggest a connection between the killing and a dispute over insurance coverage.

"We're looking at everything," the chief of detectives said. "We're looking at [Thompson's] social media. We are interviewing employees. We are interviewing family members."

Kenny added: "We're reaching out to law enforcement in Minnesota and we're also interviewing his co-workers and family members to see if there have been any specific threats against him in the past."

Thompson was named chief executive of the insurance division in April 2021. For several years prior, he ran the Medicare Advantage business within UnitedHealthcare, which has been at the center of recent industry scrutiny over risk adjustment payments and prior authorization denials.

Company leaders were gathered in New York at the annual investors' conference for parent company UnitedHealth Group when CEO Andrew Witty abruptly halted the meeting just after 8 a.m. Central time.

"We're dealing with a very serious medical situation with one of our team members," Witty said. "As a result, I'm afraid, we're going to have to bring to a close the event."

A father, husband

Paulette Thompson is a physical therapist with Bloomington-based HealthPartners. They raised two teenage sons, ages 19 and 16.

"Our hearts are with Brian's family, including our colleague Pauley Thompson and their children," Andrea Walsh, the HealthPartners chief executive, said in a message Wednesday to workers. "With many connections between our two organizations, we mourn alongside Brian's colleagues here in Minnesota and throughout the country."

Their two sons have attended Wayzata High School — one a current student and one who graduated last spring. The eldest son lettered three years on the lacrosse team, one of his coaches said.

His parents "were present around all of the team events," said assistant coach Brandon Carlson, who saw breaking news reports of Brian Thompson's death but had not realized it was the father of his former student athlete.

Brian and Paulette "were very supportive of their son," Carlson said. "He's an amazing young man and a teammate everyone would want to have."

The Thompsons' second son is a sophomore and active on the track and field team.

Wayzata High School Principal Scott Gengler sent a note to staff Wednesday morning expressing deep sympathies to the family.

"Wayzata High School has taken immediate steps to support our students and staff as they process this devastating event," Gengler wrote in a memo shared with the Minnesota Star Tribune. "Our student support teams are available and are offering a safe and supportive space for students and staff to grieve and find comfort. Additionally, our dedicated team of social workers is available to provide personalized support and guidance for those who need it."

Thompson was an executive with the company for two decades. Both he and his wife graduated from the University of Iowa. A university spokesman said he earned a bachelor's degree in business administration with an accounting major in 1997, graduating with special honors and highest distinction.

John Penshorn, a former UnitedHealth Group executive who worked with Thompson for more than a decade before retiring in 2019, called him "humble, a servant-leader and family man."

His Minnesota community

While New York law enforcement continued their manhunt, Thompson's community reeled from the news.

The block where the family has lived for seven years was subdued Wednesday morning. One neighbor said Thompson was "very quiet".

The scene at UnitedHealthcare's headquarters in Minnetonka was somber.

Snow squalls whipped the U.S., Minnesota and company flags flying at half staff as television news crews filmed. A bouquet of flowers had been laid inside the building's front entrance.

Several Minnetonka police cars camped outside the campus, and the department appeared to position a security tower to monitor the headquarters. A spokesperson for the Minnetonka police department said it's proactively stepping up patrols in the area of UnitedHealthcare's campus and has been in touch with the company's security team.

The Minnetonka police department spokesperson was not aware of any specific threats targeting the campus.

Police records show there have been many calls from company headquarters since January 2021, but a substantial number of those were 911 hang-ups.

On July 15, 11 people were arrested when the People's Action Institute staged a protest over the company's allegedly improper refusals to authorize or pay for care. UnitedHealth Group said at the time the safety of its workers was a top priority, and it had resolved the group's specific concerns, remaining open to a broader dialogue on access to care.

Other calls have included three for an "unwanted person" and one each for an unfounded threat, a civil matter and a disturbance. The civil matter involved a UnitedHealthcare client living in California who was in a reimbursement dispute in May involving $1,000.

Following Thompson's shooting, UnitedHealth Group issued a statement saying the company was working closely with the New York Police Department.

"We are deeply saddened and shocked at the passing of our dear friend and colleague," the company said. "Brian was a highly respected colleague and friend to all who worked with him. ... Our hearts go out to Brian's family and all who were close to him."

Several prominent Minnesotans, including Gov. Tim Walz and Sens. Amy Klobuchar and Tina Smith, took to social media Wednesday to express their condolences.

Steve Parente, a health economist at the University of Minnesota and former health care official in the Trump administration, said he worked with Thompson to help create a system for distributing federal financial aid to health care providers during the early days of the COVID-19 pandemic.

"He was just an incredible guy — nice, resourceful," said Parente, who worked in the White House at the time. "This is just a total tragedy."

Reporters Paul Walsh, Jessie Van Berkel, Victor Stefanescu and Louis Krauss contributed to this story.