Associate Director, Stop Loss Claims Support and Development

Benefits

Additional Information

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. Visit our website to discover how Sun Life is making life brighter for our customers, partners and communities. 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. As the Associate Director, Claim Support and Development, you will provide leadership and strategic direction for the Health and Risk Solutions teams, including Quality Assurance, Process & Developmen t , and Claims Inquiry. You will be accountable for all aspects of the Stop Loss Quality Program, ensuring superior customer service for internal and external clients while overseeing functional training programs within Stop Loss Operations. This role partners closely with Learning & Development to design and deliver comprehensive training programs across the department. You will identify opportunities for improvement through quality insights and collaborate with the Process & Development staff to create targeted training solutions. Working in close alignment with Learning & Development, you will ensure consistent, effective onboarding and ongoing development programs across Operations. You will also oversee a Claims Inquiry team that serves as the Claims Customer Service team for internal and external clients. This team will be the main point of contact for any claims-related questions, issues or escalations. As the Associate Director, you will ensure proper turnaround times are met responding to internal and external clients as well as promote superior customer service. How you will contribute: Execute and oversee a comprehensive quality assurance program, ensuring quality metrics are achieved, appropriate review volumes are completed, and identified errors are corrected. Collaborate with cross-functional partners to identify and address quality issues, root causes and system inefficiencies. Serve as the main point of contact for internal or external audits related to our quality program. Engage regularly with senior leadership, business stakeholders, and clients to influence strategy, improvements, and business solutions. Partner with Learning & Development to deliver high-quality onboarding and ongoing training for Stop Loss Operations staff, including oversight of training materials such as presentations, manuals, job aids, and e-learning modules. Lead and manage Process Analysts to ensure operational policies and procedures are current and to develop new documentation that supports operational excellence. Establish and monitor key performance metrics, targets, and benchmarks to drive continuous improvement in quality and customer service. Analyze quality results and training effectiveness, ensuring insights are translated into sustainable improvements. Stay current on industry trends, technology advancements, and best practices related to quality management and training. Lead, coach, and develop team members through continuous feedback, motivation, and performance management. Partner with the AVP, Claims Strategy and Innovation, and Stop Loss Claims Management to ensure alignment with strategic direction and client-centered execution. Manage projects and perform additional duties as assigned. What you will bring with you: Five or more years of Stop Loss and/or Medical Claims experience (preferred). Exceptional ability to build and maintain relationships with internal stakeholders and external clients. Strong communication skills, with the ability to clearly articulate strategy and value propositions. Demonstrated ability to foster trust through open, honest, and collaborative dialogue. In-depth knowledge of Stop Loss Claims philosophy and market trends. Experience with project management and change management methodologies. Strong collaboration and influence skills. Proven resilience, maintaining focus and adaptability in a changing environment. Demonstrated success presenting complex concepts to senior leaders in a clear, actionable manner. Five to seven years of people leadership experience within claims, customer service, training, or quality teams. Associate degree or equivalent experience (preferred). Strong attention to detail with a track record of delivering superior customer service. Excellent analytical, critical thinking, and operational skills. Proficiency with Microsoft

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