North Carolina
Florida
Sacramento, California
Posted: 16-Mar-23
Location: Rancho Cucamonga, California
Type: Full Time
Salary: $53,892.80 to $68,702.40
Salary Details:
Required Education:
Internal Number: 8645
Position Summary/Position
Under the direction of the Manager - Special Investigations Unit, the Privacy Investigator I has general knowledge and performs routine investigations, activities and initiatives of moderate difficulty related to the Privacy Program. The Privacy Investigator I implements, monitors and maintains a privacy compliance framework in the health care environment, including reporting to State and/or Federal regulatory agencies, to identify risks, trends and to ensure compliance with State and/or Federal contracts, laws, regulations, and guidance set forth by the Health Insurance Portability and Accountability Act of 1996 (HIPAA), Health Information Technology for Economic and Clinical Health Act of2009 (HITECH), United States Health and Human Services (HHS), the California Department of Managed Health Care (DMHC), and the California Department of Health Care Services (DHCS).
Major Functions (Duties and Responsibilities)
1. Participate in the day-to-day operations of the Privacy Program to meet Plan, department, and unit objectives.
2. Investigate routine privacy incidents in accordance with established procedures, efficiently and effectively, and ensure the quality and accuracy of the work product, including research, evidence gathering, interviewing, reviewing documents and analysis of whether a privacy allegation is substantiated and requires regulatory reporting. Coordinate with Privacy Investigators II and III to ensure appropriate action is taken to resolve the case prior to closure.
3. Assist with addressing the Privacy Program’s short and long-term goals, as developed by Management, to identify risk and ensure compliance with federal and state privacy laws.
4. Comprehend the Privacy Program’s policies and procedures, guidelines, practices, templates, and tools and use the tools to conduct investigative work.
5. Identify potential risks, non-compliance and/or alleged violations within the Plan or with external partners and issue root cause analysis/corrective action plans, as appropriate, including working with Human Resources and management to ensure consistent application of disciplinary action standards for privacy violations.
6. Assist with creating reports and analyzing data for reporting to management, the Compliance Committee, and the Governing Board.
7. Contribute to special projects related to the development of the Privacy Program (i.e.., coordinate with IT Security regarding privacy issues related to electronic media or systems). Attend and assist with meetings as it relates to privacy matters.
8. Maintain current knowledge of relevant State and Federal privacy laws and regulations.
9. Assist with responding to internal and external inquiries and provide guidance, related to privacy issues.
10. Assist with audit preparation, as needed.
11. Mentor and provide support to the Compliance Specialists.
12. Create and update desktop procedures specific to workflows and processes relevant to the Privacy Program.
Supervisory Responsibilities
Experience Qualifications
Two (2) or more years of relevant experience in a healthcare environment.
Preferred Experience
Experience in privacy investigations or other healthcare related investigations preferred.
Education Qualifications
Bachelor's degree from an accredited institution required
In lieu of the required degree, a minimum of four (4) years of additional relevant work experience is required for this position. This experience is in addition to the minimum years listed in the Experience Requirements above.
Drivers License Required
Knowledge Requirement
Knowledge of compliance principles and practices of managed care, privacy activities, and State and Federal regulatory requirements.
Skills Requirement
Interpersonal and presentation skills to communicate with internal departments and external agencies. Effective communication skills; verbal and written. Strong organizational skills and attention to detail. Good computer skills and proficiency in Microsoft Office programs including, but not limited to: Word; Excel; PowerPoint; Outlook; and Access.
Abilities Requirement
Ability to work independently with minimal direction on recurring tasks. Work collaboratively within a team environment. Ability to manage difficult, sensitive, and confidential situations with integrity and professionalism. Manage a caseload and possess a high degree of flexibility to respond rapidly to competing deadlines and changing priorities. Critical thinking and sound analytical reasoning.
Commitment to Team Culture
The IEHP Team environment requires a Team Member to participate in the IEHP Team Culture. A Team Member demonstrates support of the Culture by developing professional and effective working relationships that include elements of respect and cooperation with Team Members, Members and associates outside of our organization.
Working Conditions
Minimal physical activity; may include standing, walking, sitting, lifting, and pushing and carrying up to 25 lbs.
Position is eligible for telecommuting/remote work location model upon completing the necessary steps and receiving HR approval. The incumbent approved to telecommute may periodically be required to report to IEHP’s main campus for mandatory in-person meetings or for other business needs determined by IEHP leadership.
Work Model Location
Physical Requirements