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Privacy Compliance Consultant
2 months ago
Your Contribution
The Privacy Office team plays a pivotal role in the formulation, execution, and supervision of Blue Shield's Privacy Program. This program guarantees adherence to state and federal privacy statutes and regulations, including the Health Insurance Portability and Accountability Act (HIPAA), the Health Information Technology for Economic and Clinical Health Act (HITECH), and California's Confidentiality of Medical Information Act (CMIA). The Privacy Program Consultant will report directly to the Privacy Office Manager or the Director. In this capacity, you will be integral to the ongoing enhancement and enforcement of Blue Shield's Privacy Program.
Key Responsibilities
In this position, you will:
- Oversee compliance with state and federal privacy regulations, particularly focusing on HIPAA and HITECH.
- Design and implement training initiatives for workforce privacy, address privacy inquiries, conduct investigations into potential privacy breaches, perform privacy assessments, manage privacy-related contracts, and ensure compliance among Business Associate vendors.
- Serve as a subject matter expert on privacy issues for various business units.
- Investigate, document, and address privacy complaints and incidents reported to the Privacy Office.
- Lead investigations into privacy incidents, ensuring effective mitigation, identifying root causes, and collaborating with relevant business/operational teams to develop and implement corrective action plans to prevent recurrence of privacy violations.
- Evaluate and determine the appropriateness of requests from workforce members to disclose Protected Health Information (PHI) to third parties and/or to grant third parties access to Blue Shield PHI; assess requests for minimum necessary determinations and verify the existence of proper authorizations and/or contractual agreements.
- Assist individuals reaching out to the Privacy Office with privacy-related concerns, complaints, or allegations of violations; provide support and guidance to fellow Privacy Office team members as needed.
- Contribute to the timely creation, review, revision, and updates of privacy policies, procedures, resource guides, and educational materials.
- Perform additional privacy-related tasks as required.
Required Knowledge and Experience
- A bachelor's degree or equivalent experience is necessary.
- A minimum of 7 years of relevant experience is required.
- At least 5 years of experience in privacy-related roles within the healthcare sector is preferred.
- Certifications such as IAPP CIPP/US or HCCA CHPC are preferred.
- Comprehensive understanding of state and federal privacy laws, including HIPAA/HITECH, CMIA, and consumer protection laws like the Telephone Consumer Protection Act (TCPA) is essential; familiarity with Department of Health Care Services (DHCS) privacy requirements for Medi-Cal Managed Care Health Plans and Centers for Medicare and Medicaid (CMS) Medicare Managed Care Plans is a plus.
About Our Team
Blue Shield of California is committed to ensuring that all Californians have access to high-quality healthcare at a sustainably affordable price. We are dedicated to transforming healthcare to genuinely serve our nonprofit mission by reducing costs, enhancing quality, and improving the experience for both members and physicians. To achieve our mission, we prioritize creating a diverse, equitable, and inclusive environment where all employees can express their authentic selves and contribute fully to meet the needs of the diverse communities we serve. Our ongoing commitment to diversity, equity, and inclusion supports our values and furthers our goal of establishing a healthcare system that is worthy of our families and friends while addressing health disparities and promoting social justice.
