Director, Privacy Compliance (Director II)

Overview

On Site

$144,000 - $237,864

Full Time

Skills

privacy compliance

Job Details

Director, Privacy Compliance (Director II)

Job Description

Department(s): Office of Compliance

Reports to: Chief Compliance Officer

FLSA status: Exempt

Salary Schedule: R - $144,000 - $237,864

Applications will be accepted on a continuous basis until a sufficient number of qualified applications have been received. The deadline for the first review of applications is on Thursday, February 01, 2023 at 11:59 PM. Applicants are encouraged to apply early. Applicants that apply after the first review are not guaranteed to be considered for this recruitment. This recruitment may close at any time without notice after the first review date.

About CalOptima Health

Are you looking for a career that changes lives? As the single largest health plan in Orange County, CalOptima Health serves one in three residents with health insurance programs for low-income children, adults, seniors and people with disabilities. Our 1,500 employees are valued for their individual perspectives and contributions and benefit from flexible work schedules, recognition and opportunities to grow. If you're looking for a rewarding career supporting a meaningful mission, along with generous benefits and recognition, consider joining us at CalOptima Health!

About the Position

The Director II (Privacy Compliance) will direct and oversee privacy compliance activities and processes for CalOptima Health, including CalOptima Health Direct and its subcontracted health networks. The incumbent will be responsible for Health Insurance Portability and Accountability Act (HIPAA) compliance with the Privacy Rule and the Health Information Technology for Economic and Clinical Health Act (HITECH Act) as well as applicable state and federal regulations under CalOptima Health's Medi-Cal and Medicare lines of business. The incumbent will ensure CalOptima Health and its subcontracted health networks comply with appropriate standards, regulations, contractual provisions, federal waivers and laws. The incumbent will collaborate and interact with CalOptima Health executives and management, health network management, legal counsel, state and federal representatives and others as needed.

Duties & Responsibilities:

Cultivates and promotes a mission-driven culture of high-quality performance, with a member focus on customer service, consistency, dignity and accountability.

Directs and assists the team in carrying out department responsibilities and collaborates with the leadership team and staff to support short- and long-term goals/priorities for the department.

Manages and oversees staff, including assigning and evaluating work, making recommendations on hiring, training and setting goals, conducting performance evaluations and recommending and implementing corrective actions up to and including termination.

Plans, develops and implements strategies, processes, policies, procedures and other activities to ensure CalOptima Health and its subcontracted health networks follow state and federal standards and requirements.

Serves as the HIPAA Privacy Compliance Officer and ensures compliance with all HIPAA privacy rules, statutes and regulations. These activities include developing and implementing privacy policies, procedures and practices, including training, communication, compliance monitoring, handling complaints and compliance issues and resolving any issues involving the use or disclosure of Protected Health Information (PHI).

Develops mechanisms to monitor CalOptima Health's application of its privacy policies including its compliance with policies.

Collaborates with Information Technology Services (ITS) to determine appropriate levels of user security access and assists in monitoring this access as needed.

Develops mechanisms to limit access to PHI and to identify any unnecessary collection of PHI through ongoing monitoring processes.

Develops and monitors the process for reviewing requests to use PHI.

Develops and oversees CalOptima Health's Notice of Privacy Practices

Oversees the implementation of corrective action plans, monitors internal staff or health networks to ensure appropriate compliance with corrective action plans and makes recommendations for completion.

Reviews new or modified HIPAA regulations and related laws to determine if policy modifications are required and performs initial and periodic privacy gap and risk assessments.

Revises the privacy program in light of changes in laws, regulatory or company policy.

Interacts with and responds to state and federal regulators and representatives on HIPAA/HITECH Privacy compliance-related issues.

Works with all organizational personnel involved with any aspect of the release of PHI to ensure full coordination and cooperation pursuant to the policies, procedures and legal requirements.

Coordinates with the Cyber Security department to integrate privacy assessment, planning, policies and procedures with the related security efforts and reports to senior management on new privacy legislation and regulations.

Mitigates effects of a use or disclosure of PHI by members of CalOptima Health's workforce or business partners.

Oversees processes established for receiving, investigating, acting on and documenting all complaints related to the organization's privacy policies and procedures in coordination with management, Human Resources and/or legal counsel.

Resolves allegations of non-compliance with the corporate privacy policies or notice of information practices.

Partners with Internal Audit and Delegation Oversight management, including privacy focused components to internal audits and audits of business partners.

Reports on the status of the privacy program to the Compliance Committee and the Board of Directors or Chief Executive Officer, as requested or deemed appropriate.

Completes other projects and duties as assigned.

Experience & Education:

Bachelor's degree in Public Policy, Public Administration, Health Care Administration or related field required.

7 years of managerial experience in a managed care organization and interacting with governmental requirements and regulations with an extensive knowledge and understanding of HIPAA regulations, related federal and state laws and health care accreditation standards required.

An equivalent combination of education and experience sufficient to successfully perform the essential duties of the position such as those listed above is also qualifying.

Preferred Qualifications:

Master's degree in Public Policy, Public Administration, Health Care Administration or related field.

Certified in Healthcare Privacy Compliance (CHPC) or Certified in Healthcare Privacy and Security (CHPS).

Experience as a Health Plan Privacy Officer or equivalent experience.

Experience managing data privacy incidents and data breaches.

Experience in conducting investigations.

Experience in analyzing and interpreting data.

Experience in developing and delivering educational presentations.

Medi-Cal experience.

Physical Demands and Work Environment:

The physical demands and work environment characteristics described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

Physical demands: While performing duties of job, employee may be required to move about the organization. Employee must be able to sit for extended periods of time, as well as work at the computer for long periods. Employee is required to use hands and fingers, especially for typing on the computer and using the mouse. Must also be able to reach with hands and arms and must occasionally lift office supply boxes or laptop case, up to 25 pounds. Employee must be able to communicate, particularly for regular phone use, in meetings, face-to-face interaction and while presenting.

Work Environment: Typical office environment with minimal to moderate noise levels and controlled office temperatures.

About our Benefits & Wellness options:

At CalOptima Health, we know that a healthy and happy workforce is a thriving workforce, which is why we offer a comprehensive benefits package, including participation in the California Public Employees Retirement System (CalPERS), low-cost medical/vision/dental insurance options, and paid time off. To support quality work-life balance, we allow flexible scheduling during core business hours, telework options for some positions, work schedules that allow every other Monday or Friday off (9/80 schedule), and a wellness program featuring diverse activities. Additionally, CalOptima Health contributes 4% of pensionable earnings to a 401(a) retirement program with no required employee contribution. Employees also have access to 457(b) retirement plans with pre/post-tax contribution options.

CalOptima Health is committed to attracting, hiring, and retaining a diverse staff, where we will honor your unique experiences, identity, and perspectives. Our organization strives to create and maintain a workplace environment that is inclusive, equitable and welcoming so we can truly be Better Together.

CalOptima Health is an equal employment opportunity employer and makes all employment decisions on the basis of merit. CalOptima Health wants to have qualified employees in every job position. CalOptima Health prohibits unlawful discrimination against any employee, or applicant for employment, based on race, religion/religious creed, color, national origin, ancestry, mental or physical disability, medical condition, genetic information, marital status, sex, sex stereotype, gender, gender identity, gender expression, transitioning status, age, sexual orientation, immigration status, military status as a disabled veteran, or veteran of the Vietnam era, or any other consideration made unlawful by federal, state, or local laws. CalOptima Health also prohibits unlawful discrimination based on the perception that anyone has any of those characteristics or is associated with a person who has, or is perceived as having, any of those characteristics.

If you are a qualified individual with a disability or a disabled veteran, you may request a reasonable accommodation if you are unable or limited in your ability to access job openings or apply for a job on this site as a result of your disability.

About our Benefits & Wellness options:

Job Location: Orange, California

Position Type:

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Job Details

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