JOB DESCRIPTION

This position will allow for remote work flexibility, but the selected candidate must reside in New Mexico.

Job Summary

The Sr. HIPAA Program Manager position is primarily responsible for investigation known or suspected privacy incidents.

KNOWLEDGE/SKILLS/ABILITIES

• Respond to allegations of privacy and/or security violations. Conduct the investigation of privacy and/or security incidents involving members, providers, subcontractors, 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 incident investigation process.
• Perform data analysis, research and review of privacy violations to identify trends, patterns, outliers.
• Conduct investigations and interviews to gather additional evidence.
• Research and investigate member and/ or health plan cases through internal Alertline.
• Communicate with regulators, outside counsel, 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.
• Establish and maintain strong relationships with external agencies including the U.S. Department of Health Services Office for Civil Rights, State Medicaid agencies, Departments of Insurance, Office of Inspector General, state professional licensing boards, FBI, and state/local law enforcement.
• Prepare data requests from external regulatory agencies as required.
• Use findings to determine where there is a need for a CAP action based on line of business, severity of issue, regulatory compliance requirements and plan exposure.
• Develop and maintain relationships with key business units within specific product line and geographic region.

JOB QUALIFICATIONS

Required Education

Bachelor's Degree or equivalent combination of education and experience

Required Experience

7-9 years

Required License, Certification, Association

PMP Certification (and/or comparable coursework)

Preferred Education

Graduate Degree or equivalent combination of education and experience

Preferred Experience

10+ years

Preferred License, Certification, Association

Six Sigma Black Belt Certification, ITIL Certification desired

To all current Molina employees: If you are interested in applying for this position, please apply through the intranet job listing.

Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V.

Pay Range: $65,791.66 - $142,548.59 / ANNUAL
*Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level.

About Us

Molina Healthcare is a nationwide fortune 500 organization with a mission to provide quality healthcare to people receiving government assistance. If you are seeking a meaningful opportunity in a team-oriented environment, come be a part of a highly engaged workforce dedicated to our mission. Bring your passion and talents and together we can make a difference in the lives of others. Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V.
Job Type: Full Time
Posting Date: 04/22/2024