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: AZ , FL, GA, ID, IA, KY, MI, NE, NM, NY (outside greater-NYC), OH, TX, UT, WA (outside greater-Seattle), WI.

Fully 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.

Bilingual/ English & Spanish would be a plus

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