AVP, Member & Provider Service Delivery

Job Description

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. 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: The Opportunity: The AVP, Member & Provider Service Delivery is accountable for end-to-end operational performance across client configuration and setup , workflow configuration , member enrollment , outbound correspondence , provider credentialing , and provider operations for a large, complex dental benefits administrator. This leader ensures that operational processes, controls, and systems configuration support accurate plan administration, exceptional client/member/provider experience, regulatory compliance, and scalable growth. This role owns strategy and execution for operational readiness and ongoing performance, partnering closely with Client Implementation , Product , IT , Compliance , Claims , Network Management , and Client Engagement to deliver consistent, reliable, and auditable outcomes. What you will do: Operational Leadership & Strategy Provide strategic and day-to-day leadership across configuration, enrollment, correspondence, provider credentialing, and provider operations. Establish a high-performing culture focused on quality, productivity, continuous improvement, and client/member/provider experience. Drive operational scale and standardization while enabling flexibility for complex benefit designs and client requirements. Develop and manage annual operating plans, staffing models, budgets, and capacity planning aligned to growth forecasts and client commitments. Client Setup, Configuration & Workflow Enablement Own operational execution for new client builds , renewals, and mid-year changes, including: Benefit plan configuration (plan rules, limitations, frequencies, accumulators, eligibility rules, COB/coordination rules, exclusions) Group structure and product setup Workflow configuration and routing for operations teams and downstream processes Implement governance for configuration change management, including intake, requirements validation, testing coordination, and production release controls. Ensure configuration accuracy through ro

Required Skills