Privacy Program Specialist, Senior

Your Role

The Privacy Office team is responsible for development, implementation, and oversight of Blue Shield's Privacy Program. The Privacy Program ensures that Blue Shield and its affiliated covered entities, including Blue Shield of California Promise Health Plan, are in compliance with state and federal privacy laws and regulations, including the Health Insurance Portability and Accountability Act of 1996 (HIPAA), the Health Information Technology for Economic and Clinical Health Act of 2009 (HITECH), and California's Confidentiality of Medical Information Act (CMIA).The Privacy Program Specialist, Senior Analyst will report to the Privacy Office Manager or its Director. In this role you will be a critical part of the Privacy Office's ability to continue to successfully mature and enforce Blue Shield's Privacy Program.

Your Work

In this role, you will:

• Respond to internal and investigate, document, and respond to privacy complaints and incidents reported to the Privacy Office
• Lead privacy investigations and ensure mitigation, determine incident root cause, and work with impacted business/operational staff to ensure development and completion of corrective action plans for remediation of all privacy violations to minimize risk of recurrence
• Provide administrative and tactical support to the Chief Privacy Official and other Privacy Team members in managing privacy investigations and breaches
• Support and assist the Chief Privacy Official to define and achieve Privacy Program annual strategic goals and ongoing tactical implementation of the corporate Privacy Program
• Work with relevant business partners to proactively monitor for, identify, and resolve privacy compliance gaps and/or areas of privacy risk
• Assist, evaluate and determine appropriateness of requests from workforce members to disclose PHI to third parties and/or to allow third parties to access, use or disclose Blue Shield PHI; review requests for minimum necessary determinations and the existence of appropriate authorizations and/or contractual documentation to allow the access, use or disclosure of PHI
• Assist individuals who contact the Privacy Office with privacy related concerns, complaints or allegations of privacy violations; provide support, guidance and subject matter expertise to other Privacy Office team members as needed regarding questions they are handling
• Assist as requested in the timely creation, review, revision and updates to privacy policies, desk level procedures, resource guides, job aides and other educational tools
• Perform other privacy related duties as required

Your Knowledge and Experience

• Requires a college degree or equivalent experience
• Minimum 5 years of prior relevant experience
• Requires advanced knowledge of job area typically obtained through advanced education combined with experience
• May have practical knowledge of project management
• Compliance Analyst - Proficient in the CMS Part C & Part D regulations
• Moderate to thorough experience in managed care setting, health care industry or related field
• Experience in compliance, legal services, corporate training, systems or operations support, or another related field
• Note: Minimum of 1 - 3 years of privacy related experience with healthcare data required Knowledge of state and federal privacy laws, including HIPAA/HITECH, CMIA, and privacy related consumer protections laws, such as the Telephone Consumer Protection Act (TCPA) required; knowledge of 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 preferred.
• Ability to work collaboratively in a team, applying people management and mentoring skills required
• Strong independent judgment, problem-solving, critical and analytical thinking skills, including a "moral compass" and high integrity required

Pay Range: The pay range for this role is $85,360.00 to $128,040.00 for California.

Note: Please note that this range represents the pay range for this and many other positions at Blue Shield that fall into this pay grade. Blue Shield salaries are based on a variety of factors, including the candidate's experience, location (California, Bay area, or outside California), and current employee salaries for similar roles.

About the Company:
Blue Shield of California