Quality Oversight Senior Specialist

Sun Life • Des Moines, IA

3d

About The Position

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: Location: Must live in Iowa The opportunity: Join our Quality Management team as a Quality Oversight Senior Specialist, where your attention to detail and analytical thinking will directly impact our organization's compliance and quality objectives. This key position requires someone who thrives in a dynamic environment, can adapt to shifting priorities, and has a passion for identifying and resolving process improvements. This key position requires someone who thrives in a dynamic environment, can adapt to shifting priorities, and has a passion for identifying and resolving process improvements. The ideal candidate excels at pivoting between tasks, thinks creatively to solve complex challenges, and contributes to our commitment to exceptional service delivery. You'll thrive if you're naturally curious, detail-oriented, and passionate about continuous improvement.

Requirements

• Strong writing and communication skills with proven ability to articulate complex information clearly
• Keen observational skills and analytical curiosity, with talent for identifying and communicating process discrepancies or anomalies
• Critical thinking abilities and willingness to challenge existing processes
• Solid understanding of NCQA and/or URAC requirements
• Knowledge of federal and state healthcare quality regulations
• Beyond basic-level proficiency in Microsoft Word, PowerPoint, and Excel
• Demonstrated ability to manage competing priorities and adapt to changing requirements
• Advanced writing proficiency and technical communication experience
• Project management or coordination experience
• Healthcare data analysis and visualization skills
• Knowledge of healthcare quality management systems

Responsibilities

• Conduct comprehensive quality assurance assessments to identify process deviations and service level metric gaps
• Track quality contractual requirements and ensure ongoing compliance
• Identify potential compliance issues and communicate findings effectively to management
• Review and enhance documentation for clarity and accuracy
• Prepare and deliver quality reports to senior management and clients
• Coordinate quality assurance projects across multiple departments
• Participate in client meetings and maintain professional relationships across all organizational levels
• Foster a collaborative environment focused on mutual respect, cooperation, and information sharing

Benefits

• At Sun Life, we prioritize your well-being with comprehensive benefits, including generous vacation and sick time, market-leading paid family, parental and adoption leave, medical coverage, company paid life and AD&D insurance, disability programs and a partially paid sabbatical program.
• Plan for your future with our 401(k) employer match, stock purchase options and an employer-funded retirement account.
• Enjoy a flexible, inclusive and collaborative work environment that supports career growth.
• We’re proud to be recognized in our communities as a top employer.
• Proudly Great Place to Work® Certified in Canada and the U.S., we’ve also been recognized as a "Top 10" employer by the Boston Globe's "Top Places to Work" for two years in a row.

What This Job Offers

• Job Type: Full-time
• Career Level: Mid Level
• Education Level: No Education Listed
• Number of Employees: 5,001-10,000 employees