Compliance Analyst II, DentaQuest (Iowa Resident)

Sun Life • Des Moines, IA

1d

About The Position

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. Visit our website to discover how Sun Life is making life brighter for our customers, partners and communities. Job Description: Location: Must reside in Iowa The opportunity: Reporting to the Director of Program Integrity & Regulatory Compliance, the Compliance Analyst II is accountable for multiple functions within the organization. The Compliance Analyst II is responsible for assisting with developing a framework and support system for an effective Anti-Fraud, Waste, and Abuse Compliance Program, which serves as the catalyst for Program Integrity Compliance initiatives. Ultimately, the Compliance Analyst II will perform in a cross functional role for Program Integrity Compliance liaison matters, specific to our Iowa market, which may include additional Program Integrity Compliance activities.

Requirements

• Bachelor’s degree is required
• 3+ years of experience in compliance, legal or regulatory functions
• 1+ years of health care or insurance benefits experience
• Working knowledge of HIPAA, Medicare/Medicaid, and commercial insurance regulations.
• Ability to attend additional training as requested/deemed necessary
• Ability to attend in-person regulatory meetings with Agency personnel
• Ability to evaluate laws and regulations and identify and prioritize relevant content for updating policies and procedures
• Ability to interpret laws and regulations and communicate that information to management and line personnel
• Ability to research and investigate regulatory issues as they relate to the company’s operating subsidiaries and businesses
• Ability to discern risks and recommend controls to mitigate regulatory compliance
• Ability to assume a reasonable level of authority, to handle multiple projects and duties at the same time and to work collaboratively in a nonhierarchical department structure
• Ability to interface with various levels of management, as well as with internal and external clients and subject matter experts
• Strong writing skills, with extensive policy and procedure writing experience required
• Strong verbal communication skills
• Strong collaborative skills, as well as analytical, problem-solving and decision-making skills
• Meticulous organizational skills and attention to detail
• Must reside in the state of Iowa, USA

Nice To Haves

• Strong PowerPoint and advanced Excel capabilities preferred

Responsibilities

• Assist with review and update of annual Program Integrity Compliance Plans for State Medicaid Clients.
• Partner with Fraud Prevention and Recovery (Special Investigations Unit – SIU) to develop content for Program Integrity Compliance Plans.
• Assist with the management and review of entity disclosure of ownership and control interest information to State Agencies.
• Partner with Fraud Prevention and Recovery to conduct necessary investigations and follow-up of any compliance reports or related complaints.
• Collaborate with Legal to provide focused interpretation and guidance regarding legislation and regulations to advance the growth, innovation, and performance goals of the program to cross functional teams.
• Work with Operations to prevent improper payments, such as ensuring no payments to prohibited providers, entities, and individuals.

Benefits

• 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.

What This Job Offers

• Job Type: Full-time
• Career Level: Mid Level
• Number of Employees: 5,001-10,000 employees