Business Professional - Program/Project Manager
This a Full Remote job, the offer is available from: Arizona (USA), Florida (USA), Georgia (USA), Idaho (USA), Iowa (USA), Kentucky (USA), Michigan (USA), Nebraska (USA), New Mexico (USA), Ohio (USA), Texas (USA), Utah (USA), Wisconsin (USA) MOLINA WILL BE PROVIDING A LAPTOP. VENDOR ONLY NEEDS TO PROVIDE A HEADSET/KEYBOARD/MOUSE/DUAL MONITORS/DOCKING STATION SINCE MOLINA IS PROVIDING A LAPTOP - THERE SHOULD BE A REDUCTION IN YOUR MARKUP Sr. HIPAA Program Manager As part of Molina enterprise wide initiative leadership has requested that all candidates moving forward are sourced from the following geographical locations: AZ, FL, GA, ID, IA, KY, MI, NE, NM, NY (outside greater-NYC), OH, TX, UT, WA (outside greater-Seattle), WI. 100% remote able to work 8-5 in PST with the understanding that some work may be outside of their time zone due to member locations. Bilingual/ English & Spanish would be a plus The Senior HIPAA Program Manager position is primarily responsible for the investigation of allegations of privacy violations.
- Proven investigatory skill; ability to organize, analyze, and effectively determine risk with corresponding solutions; ability to remain objective and separate facts from opinions
- Proven ability to research and interpret regulatory requirements
- Effective interpersonal skills and customer service focus; ability to interact with individuals at all levels
- Excellent oral and written communication skills
•Intermediate/advanced skills in Microsoft Office (Word, Excel, PowerPoint, Outlook), SharePoint and Intra/Internet
- Strong logical, analytical, critical thinking and problem-solving skills
- Initiative, excellent follow-through, persistence in locating and securing needed information
- Ability to multi-task and operate effectively across geographic and functional boundaries
- Detail-oriented, self-motivated, able to meet tight deadlines
- Ability to develop realistic, motivating goals and objectives, track progress and adapt to changing priorities
- Energetic and forward thinking with high ethical standards and a professional image
- Ability to work independently
- Collaborative and team-oriented
Respond to all allegations of privacy violations. Conduct investigations of privacy incidents involving members, providers and employees
- Analyze data, contract terms, and other documentation to substantiate and/or unsubstantiate privacy allegations and identify potential patterns.
- Apply regulatory and contractual requirements as well as internal policies and procedures to the case investigation process
- Perform data analysis, research, and review of privacy violations to identify trends, patterns, outliers
- Conduct interviews to gather additional evidence
- Research and investigate member and/ or health plan cases through internal Alertline
- Communicate with members, providers, and internal stakeholders routinely regarding issues including investigative findings,
- Compile, report and present privacy incidents to the appropriate
regulatory agency
- Maintain the integrity of documentation for privacy incidents. Update case management system to ensure documentation of all calls, evidence, referrals, inquiries and case events are accurate for record keeping
purposes and for "Discovery” in court related cases
- Prepare Board of Director and ad hoc reports as necessary
- Use investigative findings and trends to determine where there is a need for a corrective action plan (CAP) based on line of business (LOB), severity of issue, regulatory compliance requirements and health plan exposure.
- Develop and maintain relationships with key business units within specific product line and geographic region.
Required Years of Experience: 5 years of healthcare experience Required Licensure / Education: Bachelor's Degree; (preferred graduate degree); equivalent combination of education and experience Fluent in Spanish This offer from "Saviance Technologies Pvt. Ltd." has been enriched by Jobgether.com and got a 75% flex score. Apply To This Job