Associate Director, Quality Assurance, DentaQuest

sunlife; United States; Hybrid; USD 110,000 - 170,000; Full time

Job summary

Sun Life U.S. is seeking an Associate Director of Quality Assurance to lead the QA function within Dental Shared Services. The role focuses on audit programs, quality monitoring, client calibration, regulatory readiness, and process improvement across multiple operational areas.

Hybrid work model with in-office collaboration at least 2 days per week. You will partner with Operations, Compliance, Training, and senior leadership to drive continuous quality improvements and ensure alignment with

Responsibilities

• Lead the design, execution, and governance of quality assurance programs across Dental Shared Services and supported operational functions.
• Oversee audit strategy, sampling methodology, quality standards, calibration processes, and reporting.

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.

DentaQuest 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.

Job Description:

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 Opportunity:

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.

What you will do:

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 internal, external, regulatory, and client audits by coordinating quality-related evidence, developing management action plans, validating remediation efforts, and ensuring audit findings are addressed timely and effectively.

Drive quality transformation initiatives, including automation, speech analytics, AWS Contact Lens adoption, end-to-end review models, enhanced reporting, and improved quality monitoring capabilities.

Evaluate resource needs, staffing models, audit volumes, and operational priorities to optimize capacity, reduce cost, and maintain adequate coverage for required quality activities.

Develop and maintain strong governance over high-risk, high-profile, and penalty-impacting clients by establishing dedicated audit processes, targeted audit criteria, and proactive communication routines.

Represent Quality Assurance in cross-functional forums, operational readiness sessions, transformation projects, vendor discussions, compliance meetings, and leadership reviews.

Prepare and present quality insights, performance trends, risks, recommendations, and improvement opportunities to senior leaders and business partners.

Promote a culture of accountability, compliance, continuous improvement, collaboratio