Quality Assurance Director – Dental Shared Services

NCSL International; Glendale, Northern (AZ, KY); Hybrid; USD 101,000 - 152,000; Full time

Job summary

Sun Life U.S. is seeking an Associate Director of Quality Assurance to lead the QA function across Dental Shared Services, ensuring accurate, compliant performance in Contact Center, Claims, Utilization Management, and Provider Operations.

You will partner with Operations, Compliance, Training, Workforce Management, and BPO leadership to translate quality insights into action plans, drive client audits, and pursue regulatory readiness and continuous improvement.

Qualifications

• Bachelor's degree or equivalent work experience.
• 5 years' experience in quality assurance, healthcare operations, dental operations, contact center operations, claims, compliance, or related business operations.
• 3 years' experience in a supervisory/management role.
• Experience supporting government, commercial, Medicaid, Medicare Advantage, or regulated healthcare programs preferred.
• Experience with reporting, dashboards, quality analytics, speech analytics, call recording tools, contact center platforms, or AWS Contact Lens preferred.

Responsibilities

• 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, collaboration, and client-focused service delivery.
• Perform other duties as assigned.

Skills

Strategic thinking

Analytical skills

Problem solving

Communication skills

Influence without authority

Change management

MS Office proficiency

Education

Bachelor's degree or equivalent work experience

Tools

Excel

PowerPoint

Word

Outlook

SharePoint

Teams

Job description

Sun Life U.S. is seeking an Associate Director of Quality Assurance to lead the QA function across Dental Shared Services, ensuring accurate, compliant performance in Contact Center, Claims, Utilization Management, and Provider Operations.

You will partner with Operations, Compliance, Training, Workforce Management, and BPO leadership to translate quality insights into action plans, drive client audits, and pursue regulatory readiness and continuous improvement.