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Program Specialist (FWA and Privacy)

CalOptima

Program Specialist (FWA and Privacy)

Orange, CA
Full Time
Paid
  • Responsibilities

     

    Under general supervision the incumbent will provide support to the Director on projects and tasks. Also, the position will perform activities related to fulfilling requests for medical records, data management, reporting, and case review for the Department. Additionally, the incumbent may coordinate a function or project(s) within the department.

     

    POSITION RESPONSIBILITIES:

    • Completes requests for access to Protected Health Information (PHI) contained in the Designated Record Set (i.e. medical records); collaborates with organizational personnel involved with the release of PHI during the fulfillment of medical record requests.
    • Prepares and mails medical records, breach notification letters and other confidential documents sent out on behalf of department. Validate accuracy of documents and attachments.
    • Compiles, analyzes, and monitors data utilizing department databases, software programs and tracking tools.
    • Performs routine and ad hoc reporting for Privacy and FWA functions and activities.
    • Assists with the development and dissemination of Privacy and FWA related communications, news articles, tip sheets, etc.  
    • Provides administrative support to the department Director and to the department staff including meeting preparation, minute taking and action item follow-up.
    • Other projects and duties as assigned.

     

    Required Skills

     

    • Critically think, problem-solve, and project coordination skills to complete assignments.
    • Coordinate the work of specialized processes or functions with all staff, members, or providers.
    • Identify issues and problems, develop solutions, and prepare recommendations, including procedures as related to department projects.
    • Communicate clearly and concisely, both verbally and in writing.
    • Manage multiple tasks, projects, programs, and deadlines, while possessing excellent time management skills, organization, and the ability to be detail oriented.
    • Collect data, identify pertinent information, and prepare reports and presentations for internal and external audiences and regulatory agencies.
    • Utilize computer and appropriate software (e.g. Microsoft Office: Word, Outlook, Excel, PowerPoint) and job specific applications/systems such as CalOptima’s Information Systems (e.g. FACETS, Guide Care).

    Required Experience

     

    EXPERIENCE & EDUCATION:

    • High school diploma or equivalent required.
    • Bachelor’s degree in Health Services, Public Health, Business Administration, and/or relevant experience in Health Care to support the department preferred.
    • 2 years of experience in a health care delivery system, including health plan, medical group, or hospital management is required.
    • 1 year of experience analyzing and solving customer problems required.

     

    KNOWLEDGE OF:

    • Regulatory compliance requirements related to Medicare and Medi-Cal
    • HIPAA (Health Insurance Portability and Accountability Act) requirements related to Personal Representatives and release of information.
    • Microsoft Office Suite of applications (Microsoft Word, Excel, PowerPoint, Access, and Outlook).

     

    Grade:  J

     

    #Indeed

     

  • Qualifications

     

    • Critically think, problem-solve, and project coordination skills to complete assignments.
    • Coordinate the work of specialized processes or functions with all staff, members, or providers.
    • Identify issues and problems, develop solutions, and prepare recommendations, including procedures as related to department projects.
    • Communicate clearly and concisely, both verbally and in writing.
    • Manage multiple tasks, projects, programs, and deadlines, while possessing excellent time management skills, organization, and the ability to be detail oriented.
    • Collect data, identify pertinent information, and prepare reports and presentations for internal and external audiences and regulatory agencies.
    • Utilize computer and appropriate software (e.g. Microsoft Office: Word, Outlook, Excel, PowerPoint) and job specific applications/systems such as CalOptima’s Information Systems (e.g. FACETS, Guide Care).