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 Knowledge and Experience Requires a bachelor's degree or High School Diploma/GED and 4 years of additional relevant experience in lieu of a degree Requires at least 7 years of prior relevant experience in healthcare privacy, healthcare compliance, health information management functions related to fulfilling individual rights requests, or another related field Requires a deep working knowledge and application of California state and federal privacy laws, including HIPAA/HITECH, CMIA, minor consent laws, and privacy-related consumer protections laws, such as the Telephone Consumer Protection Act (TCPA). Additionally, a solid understanding of Department of Health Care Services (DHCS) and Centers for Medicare and Medicaid Services (CMS) privacy requirements

Preferred:

Privacy compliance health plan experience that includes familiarity with Privacy Impact Assessments; health information management; auditing and monitoring; investigating, managing, and reporting privacy incidents; corporate compliance training

Preferred:

CIPP/US Certification or

HCCA CHPC

Certification Hybrid This role requires employees to be in-office based on our hybrid workplace model, balancing purposeful in-person collaboration with flexibility. For most teams, this means coming into the office two days each week. Employees living more than 50 miles from an office location will work with their manager to determine in-office time based on business need. Your Work In this role, you will: Support the Privacy Office's oversight of Blue Shield's compliance with applicable state and federal privacy laws, including HIPAA and HITECH Lead assigned privacy inquiries that involve responding to individual rights requests and questions, privacy complaints, and requests for privacy guidance, as the primary focus of this role Manage all aspects of assigned cases, including regulatory analysis, prompt follow-up, and timely and accurate documentation of case files. Identify matters requiring escalation and, when appropriate, direct business units in conducting root-cause analysis, and implementing mitigation and remediation efforts Assist, evaluate, and determine appropriateness of ad hoc requests from internal clients to disclose protected health information (PHI) to third parties, including employer-sponsored health plans, and/or to allow third parties access to, or use of, Blue Shield PHI Consult with internal clients as a subject matter expert, providing privacy guidance about proposed projects and enterprise-wide initiatives that involve the access, use, or disclosure of Blue Shield PHI Develop and assist with the implementation of workforce privacy trainings, privacy 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 (CAPs) on behalf of the Privacy Office, advise on CAPs issued by other business units that include privacy-related components, and conduct Privacy Impact Assessments and Data Protection Impact Assessments When internal business needs arise, assist with negotiating Business Associate Agreements, lead privacy investigations, and act as a liaison with regulatory enforcement agencies to address technical assistance letters, investigation compliance reviews, audits, and other related reviews Perform other duties as assigned