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Job Description: This position is responsible for managing the investigation of privacy complaints and reports of potential non-compliance, coordinating investigations of reported potential privacy violations, conducting ARRA breach analysis for privacy issues, and monitoring resolution of privacy issues raised or identified. This position is also responsible for responding to privacy complaints and member calls regarding privacy inquiries and complaints. This position is also responsible for conducting the regular review and revision of privacy policies and procedures, log and track privacy compliance issues, monitor reporting of disclosures of Private Information in the Disclosure Accounting Database, and maintain reports from the Privacy Program databases. Other responsibilities include:
• Investigate, or manage the investigation of, privacy-related complaints and reports of potential non-compliance with privacy policies, including determining root cause, and coordinate with the Legal Department, the Special Investigations Unit and others, as needed.
• Serve as a contact person to respond to privacy complaints and to member calls regarding privacy inquiries and complaints, including partnering with the HIPAA team (in Service) to assist with questions relating to member rights requests.
• Perform ARRA breach analysis for all privacy issues and prepare reports or notifications to regulatory agencies of privacy-related breaches, as appropriate.
• Develop privacy policies and procedures, including revisions to policies and procedures to incorporate new regulatory requirements, draft OLI updates to communicate changes in privacy policies; partner with HIPAA team and Manager, Compliance Training to deliver privacy training.
• Prepare and maintain reports on status of the Privacy Compliance Program, including results based on established reporting metrics.
• Assist in conducting periodic Privacy Office self-assessments to identify compliance gaps.
• Interact, as appropriate, with OCR or other regulatory agencies for matters relating to privacy and security of Protected Health Information, including investigating issues identified by regulatory agencies and preparing reports.
• Requires a Bachelor's degree.
• Requires a minimum of three years of compliance experience in a health care environment.
• Requires a minimum of two years of experience in compliance investigations.
• Prefers a minimum of three years of experience in the health insurance industry.
• Knowledge of the Federal and State regulatory environment in the health insurance industry, with emphasis on HIPAA privacy and security rules, ARRA/HITECH and ERISA.
• Knowledge of compliance investigation process.
Skills and Abilities:
• Organization and management of multiple priorities.
• Proficient in various Microsoft software products.
• Written and verbal communication skills.
• Data analysis.
• Attention to detail.
• Listening skills.
• Problem solving.
• Ethics and integrity.
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Axelon Services, Corp is an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender, gender identity, national origin, disability, or protected veteran status.