Sr. Manager, Quality Assurance
$76k - $115kSun Life
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: Location: 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 Sr. Manager, Quality Assurance leads the Quality Assurance function within Dental Shared Services and is accountable for the consistent execution of quality monitoring, audit, calibration, reporting, and improvement activities across supported operations. This role manages quality teams and programs, translates performance data into actionable recommendations, and partners with Operations, Compliance, Training, Workforce Management, Client Engagement, Technology, and Business Process Outsourcing partners to strengthen controls, address risk, and improve member, provider, client, and business outcomes. How you will contribute:
- Manage the day-to-day execution and continuous improvement 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.
- Establish and maintain audit procedures, sampling approaches, quality standards, calibration routines, and reporting practices aligned with contractual, regulatory, client, and internal control requirements.
- Lead, coach, and develop quality leaders and professionals by setting clear expectations, balancing workloads, monitoring productivity and accuracy, and supporting engagement, accountability, and career development.
- Analyze quality results, disputes, appeals, re-audits, and operational trends to identify root causes, emerging risks, and practical opportunities for improvement.
- Partner with Operations, Training, Workforce Management, Compliance, Client Engagement, Technology, and BPO leadership to develop and monitor corrective actions, coaching plans, training updates, and sustainable performance improvements.
- Manage client audit and calibration activities, including call and case selection, audit review, documentation preparation, meeting participation, follow-up, and timely response to client or regulatory inquiries.
- Coordinate quality support for internal, external, regulatory, and client audits; prepare evidence, contribute to management action plans, validate remediation, and track findings through closure.
- Implement quality improvement and technology initiatives, including automation, speech analytics, AWS Contact Lens, end-to-end review models, enhanced reporting, and expanded quality monitoring capabilities.
- Assess staffing, capacity, audit volumes, and competing priorities; recommend resource adjustments that support required coverage, service commitments, and cost-effective delivery.
- Maintain enhanced oversight for high-risk, high-profile, and penalty-impacting clients through targeted audit criteria, clear escalation paths, and proactive communication routines.
- Represent Quality Assurance in cross-functional forums, operational readiness activities, transformation projects, vendor discussions, compliance meetings, and leadership reviews.
- Prepare and present quality results, risks, recommendations, and improvement plans to business leaders, clients, and cross-functional partners.
- Promote a culture of accountability, compliance, continuous improvement, collaboration, and client-focused service delivery.
- Perform other duties as assigned.
- Bachelor’s degree in Business Administration, Healthcare Administration, Operations Management, or a related field, or equivalent work experience.
- Seven or more years of progressive experience in quality assurance, healthcare operations, dental operations, contact center operations, claims, compliance, or related business operations.
- Three or more years of leadership or people management experience, preferably in a quality assurance, operations, or shared services environment.
- Experience supporting government, commercial, Medicaid, Medicare Advantage, or other regulated healthcare programs preferred.
- Strong knowledge 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.
- Sound business judgment with the ability to connect quality performance to client, compliance, operational, and financial outcomes.
- Strong people leadership, coaching, performance management, and talent development skills.
- Excellent analytical and problem-solving capabilities, with the ability to interpret data, identify trends, determine root causes, and recommend practical solutions.
- Strong written and verbal communication skills, including the ability to present findings, risks, and recommendations to leaders, clients, and cross-functional audiences.
- Strong project management, prioritization, and organizational skills, with the ability to manage multiple workstreams, deadlines, and competing priorities.
- Ability to influence without direct authority and build effective partnerships across Operations, Compliance, Training, Technology, Client Engagement, and vendor teams.
- Demonstrated ability to lead teams through change, implement standardized processes, and support technology-enabled transformation.
- High attention to detail and commitment to accuracy, compliance, confidentiality, and ethical business practices.
- Proficiency with Microsoft Office applications, including Excel, PowerPoint, Word, Outlook, SharePoint, and Teams.
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