Privacy Program Specialist, Consultant

Blue Shield of California•Oakland, CA

2d•$111,540 - $188,728•Hybrid

About The Position

The Privacy Program Specialist, Consultant supports the Privacy Office in advancing and enforcing Blue Shield’s Privacy Program and its compliance with state and federal privacy laws and regulations, including HIPAA, HITECH, and California’s CMIA. The role reports to the Privacy Office Manager or Director and primarily leads assigned privacy inquiries, including individual rights requests, privacy complaints, and requests for privacy guidance. The specialist manages assigned cases from regulatory analysis through follow-up and documentation, identifies matters for escalation, and may direct business units in root-cause analysis and mitigation or remediation. The role also advises internal clients on PHI access, use, and disclosure; supports privacy training and educational materials; monitors compliance; and develops or advises on corrective action plans and impact assessments. Depending on business needs, the specialist may negotiate Business Associate Agreements, lead privacy investigations, and liaise with regulatory enforcement agencies.

Requirements

Bachelor’s degree, or a high school diploma/GED plus four years of additional relevant experience in lieu of a degree.
At least seven years of prior relevant experience in healthcare privacy, healthcare compliance, health information management functions related to fulfilling individual rights requests, or another related field.
Deep working knowledge and application of California state and federal privacy laws, including HIPAA/HITECH, CMIA, minor consent laws, and privacy-related consumer protection laws such as the Telephone Consumer Protection Act (TCPA).
Solid understanding of Department of Health Care Services (DHCS) and Centers for Medicare and Medicaid Services (CMS) privacy requirements.

Nice To Haves

Privacy compliance experience in a health plan, including familiarity with Privacy Impact Assessments, health information management, auditing and monitoring, investigating, managing, and reporting privacy incidents, and corporate compliance training.
CIPP/US certification or HCCA CHPC certification.

Responsibilities

Support the Privacy Office’s oversight of compliance with applicable state and federal privacy laws, including HIPAA and HITECH.
Lead assigned privacy inquiries, primarily responding to individual rights requests and questions, privacy complaints, and requests for privacy guidance.
Manage assigned cases, including regulatory analysis, prompt follow-up, and timely and accurate case-file documentation.
Identify matters requiring escalation and, when appropriate, direct business units in root-cause analysis and implementation of mitigation and remediation efforts.
Evaluate ad hoc internal-client requests to disclose protected health information (PHI) to third parties or allow third parties access to or use of Blue Shield PHI.
Consult with internal clients as a subject matter expert, providing privacy guidance on proposed projects and enterprise-wide initiatives involving access to, use of, or disclosure of Blue Shield PHI.
Develop and assist with implementing workforce privacy trainings, policies, desk-level procedures, resource guides, job aids, and other educational tools.
Audit and monitor compliance with the Privacy Program.
Develop and implement corrective action plans on behalf of the Privacy Office and advise on plans issued by other business units that include privacy-related components.
Conduct Privacy Impact Assessments and Data Protection Impact Assessments.
When business needs arise, assist with negotiating Business Associate Agreements, lead privacy investigations, and liaise with regulatory enforcement agencies regarding technical assistance letters, investigation compliance reviews, audits, and related reviews.
Perform other duties as assigned.