Associate Director, Quality Assurance, DentaQuest

Job Description

Sun Life U.S. is one of the largest providers of employee and government benefits, helping approximately 50 million Americans access the care and coverage they need. Through employers, industry partners and government programs, Sun Life U.S. offers a portfolio of benefits and services, including dental, vision, disability, absence management, life, supplemental health, medical stop-loss insurance, and healthcare navigation. We have more than 6,400 employees and associates in our partner dental practices and operate nationwide.

At Sun Life, we’re driven by our

Purpose:

helping our Clients achieve lifetime financial security and live healthier lives. Our values shape how we work: caring, authentic, bold, inspiring, and impactful.

When you join Sun Life, you’ll work with passionate colleagues and empowering leaders who support your growth and celebrate your contributions, so you can make a meaningful difference in our Clients' lives.

Visit our website to discover how Sun Life is making life brighter for our customers, partners and communities.

Denta Quest manages dental and vision benefits for more than 33 million Americans. Our outcomes-based, cost-effective solutions are designed for Medicaid and CHIP, Medicare Advantage, small and large businesses, and individuals. With a focus on prevention and value, we aim to make quality care accessible to improve the oral health of all.

Sun Life embraces a hybrid work model that balances in-office collaboration with the flexibility of virtual work.
Our team members and leaders are expected to foster connection and teamwork by being present in the office at least 2 days per week.

The Associate Director, Quality Assurance is responsible for leading the Quality Assurance function within Dental Shared Services, ensuring accurate, compliant, and consistent performance across core operational functions. This role provides strategic leadership for audit programs, quality monitoring, client calibration, regulatory readiness, process improvement, and quality insights that support member, provider, client, and business outcomes. The Associate Director partners across Operations, Compliance, Training, Workforce Management, Business Process Outsourcing partners, and senior leadership to identify quality trends, mitigate risk, strengthen controls, and drive continuous improvement.

• Lead the design, execution, and governance of quality assurance programs across Dental Shared Services and supported operational functions, including Contact Center, Claims, Utilization Management, Provider Operations, Complaints and Grievances, Member Enrollment, Intake and Digital Services, and Vision operations.
• Oversee audit strategy, sampling methodology, quality standards, calibration processes, and reporting to ensure quality programs align with contractual, regulatory, client, and internal control requirements.
• Manage, coach, and develop a team of quality professionals, including direct oversight of workload distribution, performance expectations, audit completion, team engagement, and professional development.
• Monitor quality performance, audit results, trends, disputes, appeals, and re-audits to identify root causes, emerging risks, and opportunities for process improvement.
• Partner with Operations, Training, Workforce Management, Compliance, Client Engagement, and BPO leadership to translate quality insights into action plans, coaching opportunities, training updates, and sustainable performance improvements.
• Lead client audit and client calibration activities, including call pulls, audit review, preparation of quality documentation, participation in client meetings, and timely response to client or regulatory inquiries.
• Support…