Director, Medicaid Compliance

Sun Life; South Portland (ME); Híbrido; USD 134.000 - 200.000; Jornada completa

Ventajas ofrecidas por este puesto de trabajo

Vacation and sick time

401(k) employer match

Stock purchase options

Disability programs

Descripción de la vacante

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

You will oversee regulatory activities, advise leaders, and strengthen controls to ensure adherence to federal and state requirements. The role partners with Privacy, Financial Crimes, Conduct, and Enterprise Compliance, supports regulatory examinations, audits, and enterprise initiatives, and offers opportunities to influence business decisions and risk

Formación

• Bachelor's degree required with 7+ years in regulatory compliance, risk management, controls, or related field.
• Deep knowledge of Medicaid, Medicare, and commercial dental regulatory requirements.
• Ability to interpret complex regulatory requirements and implement sustainable processes, controls and risk mitigation.
• Experience working with regulators, managing commitments, examinations, audits, and remediation.
• Experience with compliance testing and auditing, plus applying statistical analysis to identify trends.
• Familiarity with governance, risk, and compliance systems; Archer experience preferred.
• Strong analytical, communication, research, and presentation skills; ability to influence diverse stakeholders.
• Proficiency with MS Office and experience using AI, data visualization, and BI tools.

Responsabilidades

• Lead the Dental Regulatory Compliance Management Program including inventories, risk assessments, issue management, controls, testing, and monitoring.
• Interpret emerging laws impacting Medicaid, Medicare, and dental products and translate into controls.
• Partner with first-line leaders to strengthen compliance risk management and control ownership.
• Collaborate with Privacy, Financial Crimes, Conduct, and Enterprise Compliance to implement requirements in the Dental Unit.
• Coordinate information requests and responses for regulatory examinations and audits; track commitments.
• Develop and deliver management reporting on program effectiveness, risks, issues, testing results, and remediation progress.

Conocimientos

Analytical thinking

Critical thinking

Communication

Research

Presentation skills

Regulatory knowledge

Stakeholder collaboration

Educación

Bachelor's degree

Herramientas

Archer

MS Office

Data visualization tools

BI tools

AI tools

Descripción del empleo

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.

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.

How 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.

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 accommodation(s) to the known physical or mental limitation(s) 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] 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.

Job Category

Compliance

Posting End Date

29/11/2026