Healthcare Compliance Specialist

6 days ago


Oakland, California, United States Blue Shield of California Full time
About the Role

The Privacy Program Specialist, Consultant at Blue Shield of California is responsible for advancing and enforcing the company's Privacy Program.

Key Responsibilities:

  • Oversight of compliance with state and federal privacy laws, including HIPAA and HITECH.
  • Auditing and monitoring compliance with the Privacy Program, developing corrective action plans, advising on CAPs issued by other business units, conducting Privacy Impact Assessments and Data Protection Impact Assessments.
  • Developing workforce privacy trainings, privacy policies, desk-level procedures, resource guides, job aides, and educational tools.
  • Assisting with ad hoc requests to disclose protected health information (PHI) to third parties and/or allow third-party access to or use of Blue Shield PHI.
  • Responding to privacy complaints and incidents reported to the Privacy Office, leading investigations, documenting case files, directing root cause analysis, addressing mitigation, and working with impacted business units to develop and complete corrective action for remediation.
  • Providing subject matter expertise for internal clients on proposed projects and initiatives, responding to third-party privacy-related requests, negotiating Business Associate Agreements, and acting as a liaison with regulatory enforcement agencies.
Requirements

To be successful in this role, you will require:

  • A bachelor's degree or equivalent experience.
  • At least 7 years of prior relevant experience.
  • Prior experience in healthcare, legal services, privacy, audit, investigative services, systems or operations support, corporate training, or another related field.
  • A solid understanding of state and federal privacy laws, including HIPAA/HITECH, CMIA, and privacy-related consumer protections laws, such as the Telephone Consumer Protection Act (TCPA), as well as knowledge of Department of Health Care Services (DHCS) privacy requirements for Medi-Cal Managed Care Health Plans and Centers for Medicare or Medi-Cal and Medicaid (CMS) Medicare or Medi-Cal Managed Care Plans.
Preferred Qualifications

The preferred candidate will have:

  • Privacy healthcare-related experience that includes familiarity with Privacy Impact Assessments and Data Protection Impact Assessments; auditing and monitoring; investigating, managing, and reporting privacy incidents; health information management.
  • CIPP/US Certification or HCCA CHPC Certification.
Compensation

The estimated salary range for this role is $109,120.00 to $163,680.00 per year for locations within California.



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