Director, Medicaid Compliance

Sun Life Financial (U.S.) Services Company, Inc.; Hartford (CT); Hybrid; USD 134,000 - 200,000; Full time

Job summary

Sun Life U.S. is seeking a Director-level Medicaid Compliance expert to lead the Regulatory Compliance Management Program for the U.S. Dental Business Unit.

The role oversees regulatory activities, guides business leaders, and strengthens controls to meet federal and state requirements. The successful candidate will collaborate with Privacy, Financial Crimes, Conduct, and Enterprise Compliance teams, coordinate regulatory examinations, and drive remediation across the organization.

Qualifications

• Bachelor's degree and at least 7 years of experience in regulatory compliance, risk management, controls, or a related function within a regulated healthcare organization.
• Deep knowledge of Medicaid, Medicare, and commercial dental regulatory requirements; familiarity with regulations governing the practice of dentistry is preferred.
• Demonstrated ability to interpret complex regulatory requirements and implement sustainable compliance processes, controls, and risk mitigation strategies.
• Experience working directly with regulators and managing regulatory commitments, examinations, audit responses, and remediation activities.
• Experience conducting compliance testing, auditing operational processes and controls, and applying statistical analysis to evaluate results and identify trends.
• Working knowledge of governance, risk, and compliance systems, with Archer experience strongly preferred.
• Demonstrated ability to manage competing priorities, adapt to changing business needs, work independently, and maintain compliance expertise through professional development and industry engagement.

Responsibilities

• Lead and maintain the Dental Regulatory Compliance Management Program, including regulatory inventories, risk assessments, compliance issue management, control development, testing, and monitoring activities.
• Identify, interpret, and analyze emerging laws and regulations impacting Medicaid, Medicare, and commercial dental products; translate requirements into practical processes and controls.
• Partner with first‑line business leaders to strengthen compliance risk management and ownership of controls.
• Collaborate with Enterprise Compliance and key oversight programs to ensure requirements are implemented within the Dental Business Unit.
• Support regulatory examinations, audits, and other matters by coordinating information requests, preparing responses, tracking commitments, and remediation activities.
• Develop and deliver management reporting on compliance program effectiveness, risks, issues, testing results, trends, and remediation progress.

Skills

Analytical skills

Critical thinking

Communication

Research

Presentation skills

Influence & collaboration

Education

Bachelor's degree

Tools

MS Office

AI tools

Data visualization tools

BI tools

Archer

Job description

Company Overview

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. At Sun Life, we're driven by our Purpose: helping our Clients achieve lifetime financial security and live healthier lives. Our values shape how we work: caring, authentic, bold, inspiring, and impactful. When you join Sun Life, you'll work with passionate colleagues and empowering leaders who support your growth and celebrate your contributions, so you can make a meaningful difference in our Clients’ lives. 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 in the contiguous states plus AK.

The Opportunity

Are you a compliance professional with extensive experience navigating Medicaid, Medicare, and commercial dental regulations? Join Sun Life's U.S. Compliance team and play a key role in leading the Regulatory Compliance Management Program for the U.S. Dental Business Unit. In the Director, Medicaid Compliance role, you will oversee regulatory compliance activities that help the business identify, assess, and manage compliance risks while supporting adherence to applicable federal and state requirements. You will serve as a trusted advisor to business leaders, providing guidance on complex regulatory matters and collaborating across the organization to strengthen compliance controls and processes.

Role Overview

As a subject matter expert in Medicaid and commercial dental compliance, you will partner closely with Privacy, Financial Crimes, Conduct, and Enterprise Compliance teams to support enterprise initiatives, regulatory examinations, audits, and risk management activities. This position offers the opportunity to influence business decisions, improve operational effectiveness, and help ensure a strong culture of compliance across the organization.

What you will contribute

• Lead and maintain the Dental Regulatory Compliance Management Program, including regulatory inventories, risk assessments, compliance issue management, control development, testing, and monitoring activities.
• Identify, interpret, and analyze emerging laws and regulations impacting Medicaid, Medicare, and commercial dental products and translate requirements into practical business processes and controls.
• Partner with first-line business leaders to strengthen compliance risk management, support ownership of controls, and provide guidance on regulatory obligations.
• Collaborate with Enterprise Compliance and key oversight programs, including Privacy, Financial Crimes, and Conduct, to ensure compliance requirements are effectively implemented within the Dental Business Unit.
• Support regulatory examinations, audits, and other regulatory matters by coordinating information requests, preparing responses, tracking commitments, and facilitating remediation activities.
• Develop and deliver management reporting on compliance program effectiveness, key risks, emerging regulatory issues, testing results, trends, and remediation progress.

What you will bring with you

• Bachelor's degree and at least 7 years of experience in regulatory compliance, risk management, controls, or a related function within a regulated healthcare organization, or an equivalent combination of education, certifications, and professional experience.
• Deep knowledge of Medicaid, Medicare, and commercial dental regulatory requirements; familiarity with regulations governing the practice of dentistry is preferred.
• Demonstrated ability to interpret complex regulatory requirements and implement sustainable compliance processes, controls, and risk mitigation strategies.
• Experience working directly with regulators and managing regulatory commitments, examinations, audit responses, and remediation activities.
• Experience conducting compliance testing, auditing operational processes and controls, and applying statistical analysis to evaluate results and identify trends.
• Working knowledge of governance, risk, and compliance systems, with Archer experience strongly preferred.
• Strong analytical, critical‑thinking, communication, research, and presentation skills with the ability to influence and collaborate across diverse stakeholder groups.
• Proficiency with Microsoft Office applications and experience using artificial intelligence, data visualization, and business intelligence tools in a responsible and compliant manner.
• Demonstrated ability to manage competing priorities, adapt to changing business needs, work independently, and continuously maintain compliance expertise through professional development and industry engagement.

Salary: $133,600-$200,400
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.

Company Culture & Diversity

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.

Our Benefits

• 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 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 [e-mail] 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.

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.

Shine Together

At Sun Life, you can be your most brilliant self. Our supportive, flexible, and inclusive work environment is one where you – and your career – can thrive. Whatever your aspirations, collaborative leaders and colleagues are ready to help you learn, grow, and succeed. Make life brighter. We’re a global company with a passion for people. Our purpose is to help Clients achieve lifetime financial security and live healthier lives. As a team of 30,000 across 26 countries, our impact is far-reaching, and locally relevant. There’s power in numbers. As part of Sun Life’s growing team, you have an impact on people in your community and around the world. Shape the future. With an optimistic eye on a brighter future, we drive to innovate. Be part of leading change, push boundaries and try new ways of working. Use data to drive bold actions. Be agile and pivot as we test and learn. At Sun Life, we’re driving transformation, sustainability and innovation for our Clients, employees, partners, and communities. Join us. Together, we can make the future brighter. Join a top employer for a brighter future.