Compliance Officer II - Program Integrity Compliance Analyst

Commonwealth of Massachusetts•Boston, MA

1d•Hybrid

About The Position

The Department of Family & Medical Leave (DFML) is seeking an analytical, detail-oriented, and solutions-driven professional to support the integrity of the Commonwealth’s Paid Family & Medical Leave program. The Compliance Officer II investigates potential fraud, identifies compliance concerns, analyzes data, resolves complex issues, and supports continuous improvement to promote accurate and equitable benefit administration. The role involves working with claimants, employers, internal operations, DFML leadership, and elected officials. The position also supports program integrity initiatives, quality assurance, customer service, and timely handling of constituent concerns, case files, and public records requests. It follows a hybrid model and currently reports to the office one day a week.

Requirements

At least three years of full-time, or equivalent part-time, experience in investigatory or law enforcement work, or regulatory administration work; an equivalent combination of required experience and permitted substitutions may also qualify.
Knowledge of investigative procedures, compliance practices, and fraud detection techniques.
Experience reviewing complex information, identifying discrepancies, and making sound recommendations.
Knowledge of database structures, reporting tools, and data analysis techniques.
Ability to interpret and apply laws, regulations, policies, and procedures.
Ability to gather evidence, conduct interviews, analyze records, and document investigative findings.
Strong analytical, critical thinking, and problem-solving skills.
Ability to identify operational risks and recommend actionable improvements.
Strong written and verbal communication skills.
Ability to manage multiple priorities and respond effectively to complex or time-sensitive situations.
Ability to establish collaborative working relationships with internal and external stakeholders.
Ability to interact professionally and empathetically with individuals from diverse backgrounds.
Ability to exercise sound judgment, maintain confidentiality, and handle sensitive information with discretion.
Ability to work independently and collaboratively in a fast-paced environment.

Responsibilities

Investigate potential fraud, eligibility discrepancies, and violations of Massachusetts PFML laws and regulations.
Analyze data, reports, and cross-matched information to identify suspicious patterns, inconsistencies, and compliance concerns.
Review complaints, audit findings, and referrals to determine appropriate investigative actions and resolutions.
Gather evidence, conduct interviews, review records, and prepare investigative findings, determinations, and recommendations.
Investigate employer and employee reporting discrepancies, determine employer liability status, and review exemption requests.
Conduct quality assurance reviews across DFML business units to identify operational risks and opportunities for improvement.
Research and resolve complex claimant and employer escalations, including inquiries referred by elected officials and agency leadership.
Prepare analytical reports, maintain accurate case records, and communicate findings and decisions in a timely manner.
Support special projects, process improvements, and initiatives to strengthen program integrity and enhance the customer experience.
Update claimant payment preferences and EFT information to ensure accurate benefit payments.
Monitor Employer Live Chat and resolve employer and constituent inquiries in real time.
Respond to constituent inquiries referred by elected officials, including the Governor’s Office.
Collaborate with DFML leadership and the EOLWD Legislative Director to resolve complex constituent concerns.
Provide accurate case updates and information to agency leadership and elected officials.
Review customer satisfaction feedback and address complex claimant and employer escalations.
Manage case file and public records requests, ensuring timely and accurate responses.
Perform related duties as required.