Project/Program Manager I (Non-IT)

• The Senior HIPAA Program Manager position is primarily responsible for the investigation of allegations of privacy violations.

Duties and Responsibilities:

• 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 Alert line.
• 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 Education:

• Bachelor’s Degree; (preferred graduate degree); equivalent combination of education and experience.
• Fluent in Spanish.

Required Years of Experience:

• 5 years of healthcare experience.

• 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.
• Bilingual/ English & Spanish would be a plus.

Schedule Notes:

• 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.