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

What you will bring with you:

• 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.
• Strong understanding of quality monitoring, audit methodology, calibration, root cause analysis, corrective action planning, internal controls, and performance improvement practices.
• Experience working with BPO partners, client audits, regulatory audits, and cross-functional operational teams preferred.
• Experience with reporting, dashboards, quality analytics, speech analytics, call recording tools, contact center platforms, or AWS Contact Lens preferred.

Required Skills and Competencies

• Strategic thinking with the ability to connect quality performance to business, client, compliance, and operational outcomes.
• Excellent analytical and problem-solving capabilities, with the ability to interpret data, identify trends, and recommend practical solutions.
• Superior organizational, written and oral communication skills, particularly presentation skills.
• Ability to influence without direct authority and build effective partnerships across Operations, Compliance, Training, Technology, Client Engagement, and vendor teams.
• Demonstrated ability to lead through change, implement new processes, and support technology-enabled transformation.
• Proficiency with Microsoft Office applications, including Excel, PowerPoint, Word, Outlook, SharePoint, and Teams.

Salary:

Salary Range: $101,000 - $151,500

At our company, we are committed to pay transparency and equity. The salary range for this role is competitive nationwide, and we strive to ensure that compensation is fair and equitable. Your actual base salary will be determined based on your unique skills, qualifications, experience, education, and geographic location. In addition to your base salary, this position is eligible for a discretionary annual incentive award based on your individual performance as well as the overall performance of the business. We are dedicated to creating a work environment where everyone is rewarded for their contributions.

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