Job Description

This position serves as the subject matter expert on laws, regulations, policies, and procedures relating to HIPAA, HITECH and state laws and best practices related to the protection of protected health information (PHI) and other confidential information.  In addition, this position provides accurate and timely advice and analysis on a variety of legal issues including, but not limited to, state specific health care laws and regulations, Medicare/Medicaid rules, fraud and abuse including Stark and anti-kickback laws and regulations, patient rights, quality of care issues and informed consent, managed care contracting and negotiations, provider credentialing, and billing and reimbursement issues. 

PRIMARY JOB DUTIES: 

• Manage Privia’s Privacy Program, including but not limited to, development, implementation and maintenance of Privacy policies and procedures, training, investigation and tracking of privacy incidents and reporting inappropriate access and/or disclosure of protected health information according to the Health Insurance Portability and Accountability (HIPAA) Privacy Rule, Health Information Technology for Economic and Clinical Health Ace (HITECH) and applicable state/federal laws.

• Coordinate Privia data protection programs, including third party access process, with Privia’s IT team. 

• Fulfill the responsibilities of Privacy Officer as described in the HIPAA Privacy Rule. 

• Investigate and respond to Office of Civil Rights and HIPAA complaints, and as necessary, respond to complaints and file required reports to management and/or regulatory bodies.

• Participate in corporate governance, including but not limited to, compliance committees, risk adjustment committee, third-party access committee, and other regional or national governing bodies.

• Supervise Privia’s Privacy and Health Information Management team.

• Provide guidance on a variety of legal issues including state specific health care laws, Medicare/Medicaid regulation, fraud and abuse including Stark and anti-kickback laws and regulations, patient rights and informed consent, managed care contracting and negotiations, physician credentialing, and billing and reimbursement issues. 

• Work with the Chief Compliance Officer to provide advice and guidance on regulatory requirements and translate into organization policy and/or actionable guidance.

• Serve as a resource for leaders, staff and medical group leaders on a wide variety of legal issues relating to healthcare delivery and medical group operations.

• Provide statutory and regulatory analysis and preparation of comments to proposed regulations and other government solicitations.

• Work with the legal team to draft and negotiate a variety of contracts and agreements including, but not limited to, business associate agreements, payor contracts, vendor contracts, confidentiality and non-disclosure agreements, and ACO affiliation agreements. 

• Coordinate and lead training on new laws and regulations related to healthcare such as the Information Blocking Rule and No Surprises Act.

OTHER DUTIES:

• Provide legal support for Privia Health team members, including Chief Compliance Officer, other members of the Legal team and business and operations teams.

• Develop and implement educational programs such as briefings, roundtables, and other employee meetings.

• Establish effective working relationships with internal stakeholders across multiple departments and all Privia physician practices.

• Perform other duties as assigned.

MINIMUM QUALIFICATIONS:

• Juris Doctorate from a top ABA accredited law school and active state bar membership in good standing

• Not less than 5 years of experience in a Privacy role at a health system, hospital, large medical group, or physician delivery organization

• HIPAA  and/ or healthcare compliance certification preferred (CHC, CHP, HCISPP) 

• Demonstrated experience with federal and/or state privacy and or healthcare regulatory agencies

• Extensive knowledge of healthcare laws and regulations

INTERPERSONAL SKILLS & ATTRIBUTES:

• Excellent written and verbal communication skills

• Demonstrated leadership and management skills 

• Skilled in establishing and maintaining effective working relationships with providers, management, and staff

• Detail oriented, good with follow up, calm, stable, dependable

• Positive attitude toward company, work, clients, management, and team members.

• Critical thinker with excellent research and analytical skills

• Enjoys interacting with people and influencing HIPAA compliance best practices and behaviors

PHYSICAL DEMANDS:

The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. While performing the duties of this job, the employee is regularly required to talk, hear, and use hands and fingers to operate a computer and telephone. Specific vision abilities required by this job include close vision necessary for document review and computer work. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

TECHNICAL REQUIREMENTS (FOR REMOTE WORKERS):

In order to successfully work remotely, supporting our patients and providers, we require a minimum of 5 MBPS for Download Speed and 3 MBPS for the Upload Speed. This should be acquired prior to the start of your employment. The best measure of your internet speed is to use online speed tests like https://www.bing.com/search?q=speedtest. This gives you an update as to how fast data transfer is with your internet connection and if it meets the minimum speed requirements. Work with your internet provider if you have questions about your connection. Employees who regularly work from home offices are eligible for expense reimbursement to offset this cost.

Additional Information

All your information will be kept confidential according to EEO guidelines.

TECHNICAL REQUIREMENTS (FOR REMOTE WORKERS):

IN ORDER TO SUCCESSFULLY WORK REMOTELY, SUPPORTING OUR PATIENTS AND PROVIDERS, WE REQUIRE A MINIMUM OF 5 MBPS FOR DOWNLOAD SPEED AND 3 MBPS FOR THE UPLOAD SPEED. THIS SHOULD BE ACQUIRED PRIOR TO THE START OF YOUR EMPLOYMENT. THE BEST MEASURE OF YOUR INTERNET SPEED IS TO USE ONLINE SPEED TESTS LIKE HTTPS://WWW.SPEEDTEST.NET/. THIS GIVES YOU AN UPDATE AS TO HOW FAST DATA TRANSFER IS WITH YOUR INTERNET CONNECTION AND IF IT MEETS THE MINIMUM SPEED REQUIREMENTS. WORK WITH YOUR INTERNET PROVIDER IF YOU HAVE QUESTIONS ABOUT YOUR CONNECTION. EMPLOYEES WHO REGULARLY WORK FROM HOME OFFICES ARE ELIGIBLE FOR EXPENSE REIMBURSEMENT TO OFFSET THIS COST.