Director, Medicaid Compliance

Sun Life•Hartford, CT

3d•Hybrid

About The Position

Sun Life embraces a hybrid work model that balances in-office collaboration with the flexibility of virtual work. Our team members and leaders are expected to foster connection and teamwork by being present in the office at least 2 days per week. 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 this 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.

Requirements

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.

Nice To Haves

familiarity with regulations governing the practice of dentistry is preferred
Archer experience strongly preferred

Responsibilities

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.