Director, Medicaid Compliance

Sun Life Financial

United States

Híbrido

USD 134.000 - 200.000

Jornada completa

Hace 5 días
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Ventajas ofrecidas por este puesto de trabajo

Generous vacation and sick time
Paid family leave
Paid parental leave
Paid adoption leave
Medical coverage
Life and AD&D insurance
Disability programs
401(k) with employer match
Stock purchase plan

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. You will oversee regulatory activities, advise leadership, and drive strong controls across the organization.

In this role you will partner with Privacy, Financial Crimes, Conduct, and Enterprise Compliance teams to support examinations, audits, and risk management, shaping a culture of compliant operations across Sun Life.

Formación

  • Bachelor's degree in a regulated healthcare field or equivalent.
  • 7+ years in regulatory compliance, risk management, or related functions.
  • Deep knowledge of Medicaid, Medicare and dental regulatory requirements.
  • Experience with regulators, examinations, audits, and remediation activities.
  • Ability to interpret complex regulations and implement controls.
  • Experience with governance, risk, and compliance systems.

Responsabilidades

  • Lead the Dental Regulatory Compliance Management Program and risk assessments.
  • Interpret emerging laws for Medicaid/Medicare and dental products.
  • Collaborate with business leaders to strengthen compliance controls.
  • Coordinate with Privacy, Financial Crimes, Conduct, and Enterprise Compliance.
  • Support regulatory examinations, audits, and remediation activities.
  • Deliver management reporting on program effectiveness and risks.

Conocimientos

Regulatory compliance
Medicaid knowledge
Medicare knowledge
Audits & examinations
Compliance testing
Archer experience
Data visualization tools
MS Office proficiency
Stakeholder influence
Prioritization & independence

Educación

Bachelor's degree

Herramientas

Archer

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, 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.

We will make reasonable accommodation to the known physical or mental limitation 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 thebrightside@sunlife.com 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.

Job Category:

Compliance

Posting End Date:

29/11/2026

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