Join the World's Top Legal Talent Network

You are as unique as your background, experience and point of view. Here, you’ll be encouraged, empowered and challenged to be your best self. You'll work with dynamic colleagues - experts in their fields - who are eager to share their knowledge with you. Your leaders will inspire and help you reach your potential and soar to new heights. Every day, you'll have new and exciting opportunities to make life brighter for our Clients - who are at the heart of everything we do. Discover how you can make a difference in the lives of individuals, families and communities around the world.

Job Description:

Location: Must reside in Florida

At Sun Life, we look for optimistic people who want to make life brighter for our Clients. We understand the value of diverse cultures, perspectives, and identities, and want you to bring your full and authentic self to work. Every day, you’ll be empowered and challenged by working with dynamic colleagues to find new and innovative ways to make Sun Life the best benefits company in America.

The opportunity:

Reporting to the Director of Regulatory Compliance & Program Integrity, 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 Florida market, which may include additional Program Integrity Compliance activities.

How you will contribute:

• 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.

What you will bring with you:

• 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
• Strong PowerPoint and advanced Excel capabilities preferred
• Must reside in the state of Florida, USA

Not ready to apply yet but want to stay in touch? Join our talent community (https://pages.beamery.com/sunlifecareers/page/join-us-canada) to stay connected until the time is right for you!

Not ready to apply yet but want to stay in touch? Join our talent community to stay connected until the time is right for you!

Life is brighter when you work at Sun Life

• Excellent benefits and wellness programs to support the three pillars of your well-being – mental, physical and financial – including generous vacation and sick time, market-leading paid family, parental and adoption leave, a partially-paid sabbatical program, medical plans, company paid life and AD&D insurance as well as disability programs and more
• Retirement and Stock Purchase programs to help build and enhance your future financial security including a 401(k) plan with an employer-paid match as well as an employer-funded retirement account
• A flexible work environment with a friendly, caring, collaborative and inclusive culture
• Great Place to Work® Certified in Canada and the U.S.
• Named as a “Top 10” employer by the Boston Globe's “Top Places to Work” two years running

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.

If you are a California resident, the salary range for this position is:

• Southern California region: $85,800 - $128,700 annually
• Northern California region: $91,700 - $137,600 annually

If you are a Colorado or Nevada resident, the salary range for this position is $77,600 - $116,400 annually.

If you are a Connecticut or Maryland resident, the salary range for this position is $81,300 - $122,000 annually.

If you are a Washington or Rhode Island resident, the salary range for this position is $85,800 - $128,700 annually

If you are a New York resident, the salary range for this position is $91,700 - $137,600 annually

We consider various factors in determining actual pay including your skills, qualifications, and experience. In addition to salary, this position is eligible for incentive awards based on individual and business performance as well as a broad range of competitive benefits.

Sun Life Financial is a leading provider of group insurance benefits in the U.S., helping people protect what they love about their lives. More than just a name, Sun Life symbolizes our brand promise of making life brighter -for our customers, partners, and communities. Join our talented, diverse workforce and launch a rewarding career. Visit us at www.sunlife.com/us to learn more.

At Sun Life we strive to create a flexible work environment where our employees are empowered to do their best work. Several flexible work options are available and can be discussed throughout the selection process depending on the role requirements and individual needs.

Our Affirmative Action Program affirms our commitment to 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.

At Sun Life we strive to create a flexible work environment where our employees are empowered to do their best work. Several flexible work options are available and can be discussed throughout the selection process depending on the role requirements and individual needs.

For applicants residing in California, please read our employee California Privacy Policy and Notice.

Job Category:

Compliance

Posting End Date:

23/01/2025

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.