Manager, Compliance and Privacy Program (Hybrid) - 26-118

PriMed Management Consulting•San Ramon, CA

11h•$109,000 - $144,000•Hybrid

About The Position

The Manager of Compliance and Privacy Program assists the Compliance/Privacy Officer with implementing and maintaining the corporate Compliance and Privacy Program, maintaining supporting records and systems, and delivering timely, accurate communications to internal and external audiences. This is a hands-on working manager role responsible for intake, initial investigations, risk assessments, responses, reporting, escalation, and documentation for compliance, fraud, waste, and abuse (FWA), and privacy incidents. The Manager also maintains records for departmental and corporate projects and trains, supports, and supervises staff working on cross-functional projects, health plan audits, regulatory templates and letters, and interdepartmental compliance and privacy matters. The role works with the Compliance/Privacy Officer to ensure resources support project deadlines and service levels. The Manager supports the Compliance and Privacy Program by conducting new-hire orientation; developing and maintaining training; reviewing policies, procedures, playbooks, and training materials; administering program tools and platforms; preparing reports and committee materials; researching regulatory and contractual requirements; coordinating process-improvement projects; and tracking project status, issues, and action items. The Manager promptly informs the Compliance/Privacy Officer about incidents, findings, changes, and other relevant matters. The role leads or coordinates investigations of potential compliance, FWA, HIPAA/HITECH, and other privacy incidents, including intake, data collection, analysis, interviews, risk assessment, response, documentation, tracking, trending, escalation, and reporting. Privacy responsibilities include breach determinations and notifications under HIPAA and applicable state requirements, privacy program quality assurance and monitoring, tracking inappropriate use or disclosure of protected health information, and coordinating with the Security team. The Manager also develops and delivers privacy and compliance education, maintains privacy and breach notification policies and documentation, supports health plan and government audits, and coordinates assigned regulatory compliance letter template tasks. The position requires a bachelor’s degree and four years of related privacy experience. A master’s degree and CHC and CHCP certifications are preferred; the posting specifies that CHC must be obtained within nine months and CHCP within twelve months. The salary range is $109,000–$144,000 annually. The role is hybrid.

Requirements

Bachelor’s degree.
Four years of related privacy experience.
Three to five years of healthcare professional experience required, as stated in the posting.
Comprehensive understanding of the seven elements of a Compliance Program.
Comprehensive understanding of PHI and HIPAA guidelines.
Strong knowledge of state and federal privacy and breach notification regulations, including HIPAA, CMIA, and state and federal breach notification laws.
Strong analytical skills and critical thinking.
Strong skills in software applications including Microsoft Word, Excel, PowerPoint, Visio, Access, and Outlook.
Strong oral, written, reading comprehension, organizational, research, and negotiation skills.
Ability to exercise sound judgment, prioritize multiple tasks, and solve problems under deadline pressure and resource constraints.
Ability to work effectively with business and technical staff, independently, and as part of a team.

Nice To Haves

Master’s degree preferred.
CHC Compliance Certification preferred; the posting states it must be obtained within nine months.
CHCP Compliance Privacy Certification preferred; the posting states it must be obtained within twelve months.
Strong understanding of PriMed/Hill guidelines and other departmental processes preferred.
Familiarity with departmental software and systems, including Workday, SharePoint, PRISM, Salesforce, and Epic, preferred.

Responsibilities

Assist the Compliance/Privacy Officer with completing tasks related to the Corporate Compliance and Privacy Program and its effectiveness.
Conduct on-site new-hire orientation on Compliance, Privacy, and Security at least monthly and no more than weekly.
Develop, update, and maintain new-hire and annual Compliance and Privacy training, coordinating updates with IT Security as needed.
Maintain Compliance, Privacy, and Policy tools, including GRC, SharePoint, databases, Excel workbooks, files, and folders; administer program platforms and prepare required reports.
Review Compliance and Privacy policies and procedures at least annually, update playbooks and training materials, and promptly report changes to the Compliance/Privacy Officer.
Prepare accurate Compliance and Privacy initiative and statistical reports by established deadlines.
Develop and coordinate materials for Compliance and Privacy Program committees and meetings, including agendas, data analysis reports, presentations, and minutes.
Research complex regulatory or contractual questions and communicate relevant findings and requirements to the Compliance/Privacy Officer.
Coordinate process-improvement project activities, document and execute action items, design test cases, monitor issue logs, develop alternatives, and provide project updates.
Maintain the Compliance/Privacy Office Project List with project goals, audiences, personnel, next steps, deadlines, status, and completion dates; present during weekly Monday Morning Compliance Team meetings.
Promptly notify the Compliance/Privacy Officer of potential compliance or privacy incidents and provide backup to the team as needed.
Lead initial screening, investigation, and triage of FWA and other compliance matters, including hotline and incident-email reports; conduct or coordinate data collection, analysis, interviews, risk assessments, responses, reporting, escalation, documentation, tracking, and trending using GRC tools.
Research and evaluate changes to applicable federal and state statutes, rules, regulations, and compliance standards; prepare updates, reports, training documents, and summaries for review.
Supervise and train staff conducting compliance and FWA investigations and performing delegation tasks; support cross-training and ensure timely email acknowledgments, handovers, and GRC logging.
Perform assigned health plan delegation and government agency audit tasks, including gathering case files, policies, procedures, attestations, questionnaires, and other requested materials.
Lead initial screening, investigation, and triage of HIPAA/HITECH and other privacy matters, including required breach determinations and notification processes under HIPAA and applicable state rules.
Maintain privacy incident logs and records, and oversee intake, investigation, risk assessment, response, reporting, escalation, documentation, tracking, trending, and breach notification processes using the GRC SAI360 Privacy Incident Management Tool.
Prepare, implement, maintain, and update Privacy and Breach Notification policies and documentation; request subject-matter expert reviews and inform stakeholders of revisions.
Develop tracking systems for privacy and breach notification compliance; conduct privacy program quality assurance and follow up on previously audited areas to confirm corrective actions or recommendations were implemented.
Develop recommendations for improvement and conduct ongoing privacy compliance monitoring in coordination with other compliance and operational assessment functions.
Monitor patterns of inappropriate use or disclosure of protected health information and promptly track, investigate, and report inappropriate access or disclosure to the Compliance/Privacy Officer.
Coordinate with the Security team on aligned security and privacy compliance programs, policies, practices, and investigations; serve as a liaison to that team.
Develop and deliver training and education on state and federal privacy and breach notification requirements; maintain new-hire, annual, and targeted PHI/HIPAA compliance training.
Address privacy and breach notification inquiries, comments, and complaints, and notify the Compliance Officer, Legal, health plans, and regulatory agencies as required.
Manage, coordinate, supervise, and train staff on proactive monitoring for potential privacy breaches and report findings to the Compliance/Privacy Officer.
Draft all-staff communications reinforcing privacy best practices and assess risk and plan for long-range privacy and confidentiality compliance.
Coordinate assigned updates, testing, and maintenance of regulatory compliance letter template tools with the Letters Template team.
Maintain analytics, metrics, and related tools, including GRC, SharePoint, databases, and Excel workbooks, and keep files and folders organized.
Complete a personal goal to enhance skills in support of departmental initiatives and maintain CHC and CHCP certifications.
Perform other Compliance, Privacy, regulatory letter template, and assigned duties.