Program/Project Manager

Job Description: Sr. HIPAA Program Manager
As part of Client enterprise wide initiative leadership has requested that all candidates moving forward are sourced from the following geographical locations: Client, FL, GA, ID, IA, KY, MI, NE, NM, NY (outside greater-NYC), OH, TX, UT, WA (outside greater-Seattle), WI.
100% remote able to work 8-5 in PST with the understanding that some work may be outside of their time zone due to member locations.
Required : Bilingual/ English & Spanish

The Senior HIPAA Program Manager position is primarily responsible for the investigation of allegations of privacy violations.
Proven investigatory skill; ability to organize, analyze, and effectively determine risk with corresponding solutions; ability to remain objective and separate facts from opinions
Proven ability to research and interpret regulatory requirements
Effective interpersonal skills and customer service focus; ability to interact with individuals at all levels
Excellent oral and written communication skills
Intermediate/advanced skills in Microsoft Office (Word, Excel, PowerPoint, Outlook), SharePoint and Intra/Internet
Strong logical, analytical, critical thinking and problem-solving skills
Initiative, excellent follow-through, persistence in locating and securing needed information
Ability to multi-task and operate effectively across geographic and functional boundaries
Detail-oriented, self-motivated, able to meet tight deadlines
Ability to develop realistic, motivating goals and objectives, track progress and adapt to changing priorities
Energetic and forward thinking with high ethical standards and a professional image
Ability to work independently
Collaborative and team-oriented
Respond to all allegations of privacy violations.
Conduct investigations of privacy incidents involving members, providers and employees
Analyze data, contract terms, and other documentation to substantiate and/or unsubstantiate privacy allegations and identify potential patterns.
Apply regulatory and contractual requirements as well as internal policies and procedures to the case investigation process
Perform data analysis, research, and review of privacy violations to identify trends, patterns, outliers
Conduct interviews to gather additional evidence
Research and investigate member and/ or health plan cases through internal Alertline
Communicate with members, providers, and internal stakeholders routinely regarding issues including investigative findings,
Compile, report and present privacy incidents to the appropriate
regulatory agency
Maintain the integrity of documentation for privacy incidents. Update case management system to ensure documentation of all calls, evidence, referrals, inquiries and case events are accurate for record keeping
purposes and for Discovery in court related cases
Prepare Board of Director and ad hoc reports as necessary
Use investigative findings and trends to determine where there is a need for a corrective action plan (CAP) based on line of business (LOB), severity of issue, regulatory compliance requirements and health plan exposure.
Develop and maintain relationships with key business units within specific product line and geographic region.

Required Years of Experience: 5 years of healthcare experience
Required Licensure / Education: Bachelor s Degree; (preferred graduate degree); equivalent combination of education and experience
Fluent in Spanish