Director, Clinical Operations

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 6400 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. Internal candidates are not required to relocate near an office.

The opportunity: The Director Clinical Operations is responsible for overseeing and managing the day-to-day operations of the Clinical team within Health and Risk Solutions. This role serves as a key link between strategic initiatives set by the AVP as well as our partners in Product Development and the tactical execution carried out by the Associate Directors and their teams. The Director will ensure the efficient and effective delivery of clinical review clinical underwriting and cost containment services while also supporting the development and implementation of the Clinical 360 and Clinical 360 programs.

How you will contribute:

• Oversee day-to-day operations of the Clinical Team including Clinical Review Underwriting and Cost Containment (Clinical 360).
• Supervise and mentor the Associate Director Clinical Services and support team development and performance.
• Ensure timely and accurate completion of clinical reviews and consultations.
• Optimize workflows processes and standard operating procedures for efficiency.
• Lead implementation of strategic initiatives including Clinical 360 program enhancements.
• Collaborate cross-functionally with Product Client Success Sales and other departments.
• Monitor and report on team KPIs project status and operational performance.
• Oversee compliance with regulatory and internal policies and quality assurance standards.
• Contribute to budget planning and identify cost-saving opportunities without impacting quality.
• Leverage data analytics to support decision-making and continuous improvement.

What you will bring with you:

• Ability to work with a diverse range of people
• Bachelors degree in nursing or related field; Masters degree preferred.
• 10 years of experience in clinical operations preferably in health insurance group insurance or stop-loss insurance.
• People management experience leading clinical teams.
• Strong understanding of medical underwriting claims review and cost containment strategies.
• Excellent leadership communication and interpersonal skills.
• Proven ability to manage complex projects and drive results.
• Strong analytical and problem-solving skills.
• Experience with healthcare analytics and reporting tools.
• Ability to thrive in a fast-paced dynamic environment and manage multiple priorities.

Salary:

$129200-$193800

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 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. Were proud to be recognized in our communities as a top employer. Proudly Great Place to Work Certified in Canada and the U.S. weve also been recognized as a Top 10 employer by the Boston Globes 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 to 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.