Privacy Compliance Specialist / Job Req 688130125

PRINCIPAL RESPONSIBILITIES:

Under the direction of the Supervisor of Health Plan Privacy, the Privacy Compliance Specialist supports the compliance program by coordinating regulatory submissions internally such as filing of reports and submission of other information required by state agencies as they relate to privacy. This position is the primary liaison with the State agencies and internal departments for privacy related communications, incidents, reports and filings. The Privacy Compliance Specialist ensures submission deadlines are met and open issues are addressed to meet regulatory and contractual standards.

Principal responsibilities include:

• Serve as a point of contact for the health plan regarding all HIPAA privacy matters.
• Coordinate and complete filings, reports, ad hoc requests, and other submissions to state, federal, and local agencies including but not limited to DMHC and DHCS.
• Contact with the State agencies and regulators for daily communication, reporting, and data requests.
• 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
• Develop and maintain the HIPAA Privacy & Security Program.
  • Research incidents reported to the Compliance department and gather supporting case documentation.
  • Track and document all case incidents reported until fully resolved.
  • Report incidents to the appropriate regulatory agencies within the required timeframes.
• 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 individuals who contact the Privacy Office with privacy-related questions and provide subject matter expertise as needed for each unique, individual situation.
• Develop and maintain a calendar of reports and filings required by contract or regulations.
• Assist in receiving, digesting, and completing operational changes required resulting from the passage of new legislation, regulation, or regulatory guidance.
• At the Direction of the Director, conducts desktop reviews and assessments of privacy preparedness within the Plan and among external partners.
• Manage all required breach determination and notification processes under HIPAA and applicable State breach rules and requirements.
• Implement operational changes required resulting from the passage of new legislation, regulation, or regulatory guidance.
• Assist in the implementation of audit processes to ensure compliance with federal and state statutes and regulations and program guidance.
• Trains staff on the HIPAA Privacy Rule and privacy practices and oversees privacy related training at the Plan.
• Research questions from staff and respond to members regarding regulatory compliance to privacy practices.
• Develop and maintain a calendar of reports and filings required by contract or regulation.
• Maintain current knowledge of applicable federal and state privacy laws and accreditation standards
• Maintain knowledge of business products and related Alliance policies and procedures and alert the compliance staff of non-compliance risks to the Plan, its members and its network.
• Complete other special projects and duties as assigned.

ESSENTIAL FUNCTIONS OF THE JOB

• Communicating effectively and efficiently internally and externally.
• Writing, reporting, researching, administration, and analysis.
• Developing verbal presentations.
• Leading and participating in internal and external committees and meetings.
• Complying with the organization’s Code of Conduct, all regulatory and contractual requirements, organizational policies, procedures, and internal controls.

PHYSICAL REQUIREMENTS

• Constant and close visual work at desk or computer.
• Constant sitting and working at desk.
• Constant data entry using keyboard and/or mouse.
• Frequent use of telephone headset.
• Frequent verbal and written communication with staff and other business associates by telephone, correspondence, or in person.
• Frequent lifting of folders and various other objects weighing between 0 and 30 lbs.
• Frequent walking and standing.

Number of Employees Supervised: 0

MINIMUM QUALIFICATIONS:

EDUCATION OR TRAINING EQUIVALENT TO:

• Bachelor’s degree or equivalent experience required.
• Familiarity with Medicaid (Medi-Cal) and other publicly funded programs preferred.
• Familiarity with HIPAA Privacy Rules preferred.

MINIMUM YEARS OF ADDITIONAL RELATED EXPERIENCE:

• Three years related experience in healthcare preferably in a managed care setting.

SPECIAL QUALIFICATIONS (SKILLS, ABILITIES, LICENSE):

• Understanding of federal and state regulatory bodies and processes.
• Expert knowledge of privacy laws applicable to the health plans;
• Proficiency in correct English usage, grammar, and punctuation.
• Ability to communicate effectively, both verbally and in writing.
• Exemplary interpersonal skills including ability to work effectively as part of a team across organizational structure a must as well as the ability to work independently.
• Excellent organizational skills and orientation to detail.
• Ability to handle confidential information with appropriate discretion;
• Proven ability to manage multiple projects simultaneously and meet deadlines.
• Experience in use of computer system software such as MS Word, Excel, Access, Outlook, SharePoint, and PowerPoint.

SALARY RANGE $80,040.08-$120,060.11 ANNUALLY

The Alliance is an equal opportunity employer and makes employment decisions on the basis of qualifications and merit. We strive to have the best qualified person in every job. Our policy prohibits unlawful discrimination based on race, color, creed, gender, religion, veteran status, marital status, registered domestic partner status, age, national origin or ancestry, physical or mental disability, medical condition, genetic characteristic, sexual orientation, gender identity or expression, or any other consideration made unlawful by federal, state, or local laws. M/F/Vets/Disabled.