The posting
Job Description
Your Role
The Privacy Office develops and oversees Blue Shield’s Privacy Program. The Privacy Program ensures that Blue Shield and its affiliated covered entities, including Blue Shield of California Promise Health Plan, are in compliance with state and federal privacy laws and regulations, including the Health Insurance Portability and Accountability Act of 1996 (HIPAA), the Health Information Technology for Economic and Clinical Health Act of 2009 (HITECH), and California’s Confidentiality of Medical Information Act (CMIA). The Privacy Program Specialist, Consultant reports to the Privacy Office Manager or Director and plays an essential role in advancing and enforcing Blue Shield’s Privacy Program.
Responsibilities
Your Work
In this role, you will:
- Support the Privacy Office’s oversight of Blue Shield's compliance with applicable state and federal privacy laws, including HIPAA and HITECH
- Lead assigned privacy inquiries that involve responding to individual rights requests and questions, privacy complaints, and requests for privacy guidance, as the primary focus of this role
- Manage all aspects of assigned cases, including regulatory analysis, prompt follow-up, and timely and accurate documentation of case files. Identify matters requiring escalation and, when appropriate, direct business units in conducting root-cause analysis, and implementing mitigation and remediation efforts
- Assist, evaluate, and determine appropriateness of ad hoc requests from internal clients to disclose protected health information (PHI) to third parties, including employer-sponsored health plans, and/or to allow third parties access to, or use of, Blue Shield PHI
- Consult with internal clients as a subject matter expert, providing privacy guidance about proposed projects and enterprise-wide initiatives that involve the access, use, or disclosure of Blue Shield PHI
- Develop and assist with the implementation of workforce privacy trainings, privacy policies, desk level procedures, resource guides, job aids, and other educational tools
- Audit and monitor compliance with the Privacy Program, develop and implement corrective action plans (CAPs) on behalf of the Privacy Office, advise on CAPs issued by other business units that include privacy-related components, and conduct Privacy Impact Assessments and Data Protection Impact Assessments
- When internal business needs arise, assist with negotiating Business Associate Agreements, lead privacy investigations, and act as a liaison with regulatory enforcement agencies to address technical assistance letters, investigation compliance reviews, audits, and other related reviews
- Perform other duties as assigned
Qualifications
Your Knowledge and Experience
- Requires a bachelor’s degree or High School Diploma/GED and 4 years of additional relevant experience in lieu of a degree
- Requires at least 7 years of prior relevant experience in healthcare privacy, healthcare compliance, health information management functions related to fulfilling individual rights requests, or another related field
- Requires a deep working knowledge and application of California state and federal privacy laws, including HIPAA/HITECH, CMIA, minor consent laws, and privacy-related consumer protections laws, such as the Telephone Consumer Protection Act (TCPA). Additionally, a solid understanding of Department of Health Care Services (DHCS) and Centers for Medicare and Medicaid Services (CMS) privacy requirements
- Preferred: Privacy compliance health plan experience that includes familiarity with Privacy Impact Assessments; health information management; auditing and monitoring; investigating, managing, and reporting privacy incidents; corporate compliance training
- Preferred: CIPP/US Certification or HCCA CHPC Certification
Hybrid
This role requires employees to be in-office based on our hybrid workplace model, balancing purposeful in-person collaboration with flexibility. For most teams, this means coming into the office two days each week.
Employees living more than 50 miles from an office location will work with their manager to determine in-office time based on business need.
About Blue Shield of California
As of January 2025, Blue Shield of California became a subsidiary of Ascendiun. Ascendiun is a nonprofit corporate entity that is the parent to a family of organizations including Blue Shield of California and its subsidiary, Blue Shield of California Promise Health Plan; Altais, a clinical services company; and Stellarus, a company designed to scale healthcare solutions. Together, these organizations are referred to as the Ascendiun Family of Companies.
At Blue Shield of California, our mission is to create a healthcare system worthy of our family and friends and sustainably affordable. We are transforming health care in a way that genuinely serves our nonprofit mission by lowering costs, improving quality, and enhancing the member and physician experience.
To achieve our mission, we foster an environment where all employees can thrive and contribute fully to address the needs of the various communities we serve. We are committed to creating and maintaining a supportive workplace that upholds our values and advances our goals.
Blue Shield is a U.S. News Best Company to work for, a Deloitte U.S. Best Managed Company and a Top 100 Inspiring Workplace. We were recognized by Fair360 as a Top Regional Company, and one of the 50 most community-minded companies in the United States by Points of Light. Here at Blue Shield, we strive to make a positive change across our industry and communities – join us!
Our Values:
- Honest. We hold ourselves to the highest ethical and integrity standards. We build trust by doing what we say we're going to do and by acknowledging and correcting where we fall short.
- Human. We strive to listen and communicate effectively, showing empathy by understanding others' perspectives.
- Courageous. We stand up for what we believe in and are committed to the hard work necessary to achieve our ambitious goals.
Our Workplace Model
We believe in fostering a workplace environment that balances purposeful in-person collaboration with flexibility - providing clear expectations while respecting the diverse needs of our workforce. Our workplace model is designed around intentional in-person interaction, collaboration, connection, creativity and flexibility:
- For most teams, this means coming into the office two days per week.
- Employees living more than 50 miles from an office location, out of state employees, and employees in certain member-facing roles should work with their manager to determine in-office time based on business need.
- For employees with medical conditions that may impact their ability to work in-office, we are committed to engaging in an interactive process and providing reasonable accommodations to ensure their work environment is conducive to their success and well-being.
The Company reserves the right to require more presence in the office based on business needs, and requirements are subject to change with periodic reviews.
Physical Requirements:
Office Environment - roles involving part to full time schedule in Office Environment. Based in our physical offices and work from home office/deskwork - Activity level: Sedentary, frequency most of work day.
Please click here for further physical requirement detail.
Equal Employment Opportunity:
External hires must pass a background check/drug screen. Qualified applicants with arrest records and/or conviction records will be considered for employment in a manner consistent with Federal, State and local laws, including but not limited to the San Francisco Fair Chance Ordinance. All qualified applicants will receive consideration for employment without regards to race, color, religion, sex, national origin, sexual orientation, gender identity, protected veteran status or disability status and any other classification protected by Federal, State and local laws.
