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Blue Shield of California

Privacy Program Specialist, Consultant

Blue Shield of California, Oakland, California, United States, 94616


Privacy Program Specialist, Consultant at Blue Shield of California summary: The Privacy Program Specialist, Consultant plays a pivotal role in managing and enforcing Blue Shield's Privacy Program, ensuring compliance with federal and state privacy regulations including HIPAA and HITECH. This position involves responding to privacy complaints, conducting investigations, and guiding internal clients on privacy matters related to projects and initiatives. The specialist also oversees the development of privacy training and policies, negotiates Business Associate Agreements, and collaborates with regulatory agencies to maintain compliance.

Your Role

The Privacy Office develops and oversees 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, Consultant reports to the Privacy Office Manager or Director and plays an essential role in advancing and enforcing Blue Shield’s Privacy Program. Your Work

In this role, you will:

Be responsible for the oversight of Blue Shield's compliance with state and federal privacy laws, including HIPAA and HITECH

Respond to privacy complaints and incidents reported to the Privacy Office, lead assigned privacy investigations, timely and accurately document case files, direct investigations into root cause analysis, address mitigation, and work with impacted business units to develop and complete corrective action for remediation and to minimize risk of recurrence

Consult with internal clients, as a subject matter expert, to provide privacy guidance about proposed projects and initiatives

Respond to third-party privacy-related requests

Develop and assist with the implementation of workforce privacy trainings, privacy policies, desk level procedures, resource guides, job aides, and other educational tools

Negotiate Business Associate Agreements

Act as a liaison with regulatory enforcement agencies to address technical assistance letters, investigation compliance reviews, audits, and other related reviews

Auditing and monitoring compliance with the Privacy Program, developing and implementing corrective action plans (CAPs) on behalf of the Privacy Office, advising on CAPs issued by other business units with privacy-related components, conducting Privacy Impact Assessments and Data Protection Impact Assessments

Assist, evaluate, and determine appropriateness of ad hoc requests from internal clients to disclose protected health information (PHI) to third parties and/or to allow third parties access to, or use of, Blue Shield PHI

Perform other duties as assigned

Your Knowledge and Experience

Requires a bachelor's degree or equivalent experience

Requires at least 7 years of prior relevant experience

Requires prior experience in healthcare, legal services, privacy, third-party cybersecurity incident management, investigative services, audit, systems or operations support, corporate training, or another related field

Requires 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: Privacy healthcare-related experience that includes a familiarity with Privacy Impact Assessments and Data Protection Impact Assessments; auditing and monitoring; investigating, managing, and reporting privacy incidents; health information management

Preferred: CIPP/US Certification or HCCA CHPC Certification

Pay Range:

The pay range for this role is: $ 109120.00 to $ 163680.00 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.

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Keywords: privacy compliance, HIPAA, HITECH, healthcare privacy, privacy training, data protection, privacy investigations, Business Associate Agreements, regulatory compliance, privacy program management