Director, Medicaid Compliance

Sun Life Assurance Company of Canada; United States; Híbrido; USD 140.000 - 180.000; Jornada completa

Descripción de la vacante

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

This role partners with Privacy, Financial Crimes, Conduct, and Enterprise Compliance to strengthen controls and support regulatory examinations across the organization. Hybrid work is available in the contiguous states plus Alaska. The role requires deep knowledge of Medicaid, Medicare, and commercial dental regulations, with experience in audits,

Formación

• Bachelor's degree required; 7+ years in regulatory compliance, risk management, or related function in a regulated healthcare setting.
• Deep knowledge of Medicaid/Medicare and commercial dental regulations; familiarity with dentistry regulations is preferred.
• Ability to interpret complex regulatory requirements and implement sustainable compliance processes and controls.
• Experience working with regulators and managing regulatory commitments, examinations, audits, and remediation activities.
• Experience conducting compliance testing and auditing operational processes and controls; ability to analyze results for trends.

Responsabilidades

• Lead the Dental Regulatory Compliance Management Program, including risk assessments and control testing.
• Interpret emerging Medicaid, Medicare, and dental regulations and translate requirements into practical controls.
• Partner with business leaders to strengthen compliance risk management and control ownership.
• Collaborate with Privacy, Financial Crimes, Conduct, and Enterprise Compliance for program alignment.
• Coordinate information requests and responses for regulatory examinations and audits.

Conocimientos

Regulatory compliance

Risk management

Controls

Governance

Data analysis

Communication

Presentation

Regulatory examinations

Educación

Bachelor's degree

Herramientas

Archer

Microsoft Office

Data visualization tools

Descripción del empleo

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.

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, regulatory matters by coordinating information requests and prepare responses.

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