Senior Compliance and Privacy Specialist - Health Plan

 
Position: Senior Compliance and Privacy Specialist - Health Plan

Job ID: 154375

Location: US-TX-Bellaire

Department: TCHP PRIVACY

Talent Area: Professional - Non-Clinical

Full/Part Time: Full-Time

Regular/Temporary: Regular

Shift: 8am-5pm

About Texas Children's Hospital

Texas Children’s Health Plan Founded in 1996, Texas Children’s Health Plan is the nation's first health maintenance organization (HMO) created just for children. We provide STAR/Medicaid and Children's Health Insurance Program (CHIP) to pregnant women, teens, children and adults in Houston and surrounding areas. Currently, the Health Plan has more than 375,000 members who receive care from our network of more than 1,100 primary care physicians, 3,200 specialists, and 70 hospitals. Texas Children's Health Plan is also the largest combined STAR/CHIP Managed Care Organization in the Harris County service area.   To join our community of 14,000+ dedicated team members, visit texaschildrenspeople.org for career opportunities. You can also learn more about our amazing culture at infinitepassion.org.   Texas Children’s is proud to be an equal opportunity employer. All applicants and employees are considered and evaluated for positions at Texas Children's without regard to mental or physical disability, race, color, religion, gender, national origin, age, genetic information, military or veteran status, sexual orientation, gender identity, marital status or any other protected Federal, State/Province or Local status unrelated to the performance of the work involved.  

Summary:

We are searching for a Senior Compliance & Privacy Specialist -- someone who works well in a fast-paced setting. In this position, you will oversee the daily operations of our organization’s privacy program. You will also be responsible for privacy incident investigations, auditing and monitoring processes, and all education and training initiatives. In this role, health plan experience is essential to be successful.

 

Think you’ve got what it takes?



Responsibilities :

Job Duties & Responsibilities

  • Conducts initial screening, timely investigation and triaging of privacy matters. This includes data collection, analyses, interviews, and report writing
  • Maintains appropriate documentation for all privacy investigation activities, including a detailed log of all allegations, information related to affected parties, investigation details, and breach risk assessments
  • Develops and delivers privacy-related education and training
  • Ensures communications related to Privacy, HIPAA and other potential Compliance-related issues are completed in an appropriate and timely manner
  • Reports privacy breaches to Texas Health and Human Services Commission (HHSC) and Office of Civil Rights, in accordance with the required timeframes
  • Establishes and maintains open line of communication with the following areas: Members Services, Utilization Management, Provider Relations, Business Operations, Legal Services, Controls and Compliance, and HHSC Privacy


Qualifications:

Skills & Requirements

  • High school diploma or GED required
  • CPC, CCS-P, RHIA, CCS, or CHC certification preferred
  • 9 years in a healthcare regulatory environment including specific experience in project management and audit type work such as planning, supervising, executing, and reviewing audits, reviews or investigations required
  • Health plan experince preferred
  • A bachelors degree in healthcare or business related field can substitute for 4 years’ experience


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