Privacy Investigator II (Hybrid Work Schedule)

Date: Jun 16, 2022

Location: Rancho Cucamonga, CA, US

Company: Inland Empire Health Plans

Job Requisition ID: 6053 


Position Summary/Position


Under the direction of the Manager - Special Investigations Unit, the Privacy Investigator II has experience with and performs routine and complex investigations, activities and initiatives of moderate to complex difficulty related to the Privacy Program. The Privacy Investigator II implements, monitors and maintains a privacy compliance framework in the health care environment, including reporting to State and/or Federal regulatory agencies, to identify risks, trends and to ensure compliance with State and/or Federal contracts, laws, regulations, and guidance set forth by the Health Insurance Portability and Accountability Act of 1996 (HIPAA), Health Information Technology for Economic and Clinical Health Act of 2009 (HITECH), United States Health and Human Services (HHS), the California Department of Managed Health Care (DMHC), and the California Department of Health Care Services (DHCS).

Major Functions (Duties and Responsibilities)


1. Participate in the day-to-day operations of the Privacy Program to meet Plan, department, and unit objectives. 
2. Investigate routine and complex privacy incidents in accordance with established procedures, efficiently and effectively, and ensure the quality and accuracy of the work product, including research, evidence gathering, interviewing, reviewing documents and analysis of whether a privacy allegation is substantiated and requires regulatory reporting. Coordinate with Privacy Investigator III to ensure appropriate action is taken to resolve the case prior to closure.
3. Address the Privacy Program’s short and long-term goals, as developed by Management, to identify risk and ensure compliance with federal and state privacy laws.
4. Review the Privacy Program’s policies and procedures, guidelines, practices, templates and tools and make recommendations for revisions, as identified.
5. Identify potential risks, non-compliance and/or alleged violations within the Plan or with external partners and issue root cause analysis/corrective action plans, as appropriate, including working with Human Resources and management to ensure consistent application of disciplinary action standards for privacy violations.
6. Collaborate with internal partners on privacy initiatives and assist with tracking and trending to identify potential risks.
7. Coordinate with the Compliance Department’s Auditing and Monitoring Unit as it relates to privacy issues and help implement process improvement measures to prevent, correct, and mitigate those risks in the future.
8. Create reports and analyze data for reporting to management, the Compliance Committee and the Governing Board.
9. Assist with special projects related to the development of the Privacy Program (i.e., coordinate with IT Security regarding privacy issues related to electronic media or systems).  Participate in and coordinate meetings as it relates to privacy matters.
10. Maintain current knowledge of relevant State and Federal privacy laws and regulations and assist with adaptation of business practices to ensure compliance.
11. Respond to internal and external inquiries and provide guidance, related to privacy issues.
12. Assist with audit preparation and participate, as needed.
13. Provide support to the Compliance Specialists with monitoring intake and initiating cases, when needed.
14. Create and update desktop procedures specific to workflows and processes relevant to the Privacy Program.

Supervisory Responsibilities

Leading: Self

Experience Qualifications


3 or more years relevant professional experience in a health care environment, specific to conducting privacy related investigations, including state and federal reporting requirements.

Education Qualifications


Bachelor's degree in a related field from an accredited institution required.

Professional Certification


Professional certifications such as Certified in Healthcare Privacy Compliance (CHPC) or similar certification preferred.

Drivers License Required


Knowledge Requirement


Knowledge and experience of compliance principles and practices of managed care, privacy activities, and State and Federal regulatory requirements.

Skills Requirement


Critical thinking and sound analytical reasoning. Strong interpersonal and presentation skills to communicate with internal departments and external agencies. Effective communication skills; verbal and written. Strong organizational skills. Good computer skills and proficiency in Microsoft Office programs including, but not limited to: Word; Excel; PowerPoint; Outlook and Access.

Abilities Requirement


Ability to work independently and collaboratively within a team environment. Ability to work independently, apply knowledge, and address situations appropriately with minimal guidance. Ability to manage difficult, sensitive and confidential situations with integrity and professionalism. Attention to detail. Ability to manage a caseload and possess a high degree of flexibility to respond rapidly to competing deadlines and changing priorities.

Commitment to Team Culture


The IEHP Team environment requires a Team Member to participate in the IEHP Team Culture. A Team Member demonstrates support of the Culture by developing professional and effective working relationships that include elements of respect and cooperation with Team Members, Members and associates outside of our organization.

Working Conditions


Minimal physical activity; may include standing, walking, sitting, lifting, and pushing and carrying up to 25 lbs.


Starting Salary: [[ 61,425.73 ]]  - [[ 78,303.47 ]]  

Pay rate will commensurate with experience


Inland Empire Health Plan (IEHP) is the largest not-for-profit Medi-Cal and Medicare health plan in the Inland Empire. We are also one of the largest employers in the region. With a provider network of more than 6,000 and a team of more than 2,000 employees, IEHP provides quality, accessible healthcare services to more than 1.2 million members. And our mission and core values help guide us in the development of innovative programs and the creation of an award winning workplace. As the healthcare landscape is transformed, we’re ready to make a difference today and in the years to come. Join our Team and Make a Difference with us! IEHP offers a Competitive salary and a benefit package with a value estimated at 35% of the annual salary, including medical, dental, vision, team bonus, and retirement plan.


Nearest Major Market: Riverside
Nearest Secondary Market: Los Angeles