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 Consultant 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:
- Be responsible for the oversight of Blue Shield's compliance with state and federal privacy laws, including the privacy component of the Health Insurance Portability and Accountability Act of 1996 (HIPAA) and the Health Information Technology for Economic and Clinical Health Act (the HITECH Act) of 2009
- Develop and implement workforce privacy training programs, respond to privacy inquiries, conduct investigations of potential privacy violations, conduct privacy assessments, manage privacy-related contracting, and monitor and oversee Business Associate vendor privacy compliance
- Act as a subject matter expert to business units on privacy matters
- 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
- 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 with regard to 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 bachelor's degree or equivalent experience
- Requires at least 7 years of prior relevant experience
- Minimum of 5 years of privacy related experience with healthcare data preferred
- IAPP CIPP/US Certification or HCCA, CHPC Certification preferred
- Sound 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
Pay Range: The pay range for this role is $109,120.00 to $163,680.00 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.
