Director Stop Loss Rn Jobs in Springfield, MA (NOW HIRING)

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.

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 & Development, 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 Excel, PowerPoint, Word, Visio, and/or Project.

Salary $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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We are committed to fostering an inclusive environment where all employees feel they belong, are supported and empowered to thrive. We are dedicated to building teams with varied experiences, backgrounds, perspectives and ideas that benefit our colleagues, clients, and the communities where we operate. We encourage applications from qualified individuals from all backgrounds.

Life is brighter when you work at Sun Life

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. Visit our website to learn more about our benefits and recognition within our communities.

We will make reasonable accommodations to the known physical or mental limitations of otherwise-qualified individuals with disabilities or special disabled veterans, unless the accommodation would impose an undue hardship on the operation of our business. Please email thebrightside@sunlife.comto request an accommodation.

For applicants residing in California, please read our employee California Privacy Policy and Notice.

We do not require or administer lie detector tests as a condition of employment or continued employment.

Sun Life will consider for employment all qualified applicants, including those with criminal histories, in a manner consistent with the requirements of applicable state and local laws, including applicable fair chance ordinances.

All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, or status as a protected veteran.