B

Blue Shield of California

California nonprofit health insurance provider

Privacy Program Specialist - Consultant

Full-Time
$125.7k - $188.7k/yr
Senior
Bachelor's
California, USA+1 moreMore locations: Oakland, CA, USA
HybridThe role is generally in-office two days each week. Employees living more than 50 miles from an office will determine in-office time with their manager.
Risk & CompliancePrivacy & Data Protection

About the job

Requirements
  • A bachelor's degree, or a high school diploma/GED plus four additional years of relevant experience in lieu of a degree.
  • Seven years of prior relevant experience.
  • Prior experience in healthcare privacy, cybersecurity incident management, investigative services, or a related field.
  • A solid understanding of state and federal privacy laws, including the Health Insurance Portability and Accountability Act, the Health Information Technology for Economic and Clinical Health Act, the Confidentiality of Medical Information Act, and privacy-related consumer protection laws such as the Telephone Consumer Protection Act.
  • Knowledge of Department of Health Care Services privacy requirements for Medi-Cal Managed Care Health Plans and Centers for Medicare or Medi-Cal and Medicaid requirements for Medicare or Medi-Cal Managed Care Plans.
  • Strong organizational skills, independent judgment, problem-solving, critical and analytical thinking, work ethic, and ethical judgment.
  • Ability to work collaboratively, perform duties with minimal supervision, multitask, and deliver quality work in a highly regulated and changing corporate environment.
  • Proficiency in Microsoft Word, Access, Excel, PowerPoint, and Outlook.
Responsibilities
  • Oversee Blue Shield's compliance with state and federal privacy laws, including the privacy components of the Health Insurance Portability and Accountability Act and the Health Information Technology for Economic and Clinical Health Act.
  • Lead assigned privacy investigations, document case files accurately and timely, investigate root causes, address mitigation, and work with impacted business units to complete corrective actions and minimize recurrence risk.
  • Consult with internal clients on proposed projects and initiatives, provide privacy guidance, and serve as a privacy subject matter expert.
  • Respond to privacy-related requests and inquiries.
  • Develop and assist with implementing workforce privacy training programs, privacy policies, desk-level procedures, resource guides, job aids, and other educational tools.
  • Liaise with regulatory enforcement agencies regarding technical assistance letters, investigation compliance reviews, audits, and related reviews.
  • Evaluate ad hoc requests from internal clients to disclose protected health information to third parties or allow third parties to access or use Blue Shield protected health information.
  • Perform other assigned duties.
Desired Qualifications
  • Extensive experience directly handling investigations.
  • Healthcare privacy experience involving Privacy Impact Assessments, Data Protection Impact Assessments, auditing and monitoring, privacy incident investigation, management and reporting, and health information management.
  • Certified Information Privacy Professional/United States certification or Health Care Compliance Association Certified Healthcare Privacy Compliance certification.
  • Experience with and knowledge of compliance or privacy incident management software.

About the company

B

Blue Shield of California

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Blue Shield of California is a nonprofit health plan provider that offers medical insurance options for individuals, families, and employers within California. It operates as a mutual benefit corporation and maintains a broad network of healthcare professionals and facilities, enabling members to access care and manage claims through an online portal. Its services include preventive care programs and digital health coaching, with prior authorization required for certain medical, surgical, and some prescription drugs to control costs and ensure medical necessity. The company draws a substantial portion of its membership from CalPERS and focuses on delivering stable, affordable access to care within the state. Its goal is to provide members with reliable health coverage, a wide provider network, and tools to manage their health and expenses efficiently.

Company Size

5,001-10,000

Company Stage

N/A

Total Funding

N/A

Headquarters

null

Founded

1939

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Simplify Jobs

Simplify's Take

What believers are saying

  • September 2026 Virtual Blue expansion adds 260,000 members, boosting retention and employer appeal.
  • August 2026 Dignity, Providence, and Cedars-Sinai renewals protect network breadth across California.
  • Food as Health and fire-assistance programs strengthen brand trust while supporting Medi-Cal members.

What critics are saying

  • September 2026 ghost-network lawsuit survived dismissal; discovery threatens damages and reputational harm.
  • WARN filings in 2026 affected 205 workers, signaling ongoing restructuring and cost pressure.
  • California provider dependence on Cedars-Sinai, Providence, and Dignity Health creates contract-break existential risk.

What makes Blue Shield of California unique

  • Blue Shield of California combines nonprofit status with statewide California-only health plan distribution.
  • September 2026 Virtual Blue expansion reaches 410,000 members with $0 out-of-pocket virtual care.
  • September 2026 Food as Health invests $600,000 in nutrition-based chronic-care programs.

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Company News

Blue Shield of California
Oct 12th, 2026
Blue Shield of California ranked among Forrester's top health insurers for brand and Customer Experience.

Blue Shield of California ranked among Forrester's top health insurers for brand and Customer Experience. Nonprofit health plan ranked No. 3 nationally for Total Experience among health insurers. October 12, 2026 As Californians prepare for open enrollment this fall, choosing a health plan is about more than coverage. People evaluate health plans not only by their benefits, but also by what the organization stands for, the commitments it makes, and the experiences it delivers, from accessing care to finding information and getting support when it's needed. Blue Shield of California's work to align its brand promise with the experiences it delivers is reflected in Forrester's U.S. Health Insurers Total Experience Score Rankings for 2026, where Blue Shield ranked No. 3 among 16 health insurers nationwide and was recognized as a Strong Performer. Blue Shield's score also increased 7.1 points from 55.9 in 2025 to 63.0 in 2026, five points above the industry average, remaining in Forrester's Leading Quadrant of the growth grid for U.S. health insurers. Blue Shield believes this recognition underscores its progress in building trust through both its brand promise and member experience. "We're focused on making healthcare simpler and more responsive to the needs of the people we serve," said Ellen Sexton, executive vice president and chief growth officer at Blue Shield of California. "For us, this recognition reflects exciting progress, but more importantly it reinforces our commitment to listening to our members, earning their trust, and continuously improving the experiences they have every day." Blue Shield's 2026 results Blue Shield believes its performance reflects strong momentum across key measures: * No. 3 among 16 U.S. health insurers evaluated * Score of 63.0, up 7.1 points from 2025 * Five points above the healthcare industry average * Recognized as a Strong Performer * Positioned in Forrester's Leading Quadrant of the growth grid for U.S. health insurers For Blue Shield, the findings reflect continued progress in its efforts to simplify healthcare, strengthen support, and deliver greater value for members and the broader marketplace. What is Total Experience? Forrester has measured Customer Experience in the health insurance industry since 2016. In 2025, it expanded its methodology to include Brand Experience, creating a new Total Experience score that evaluates how well an organization's reputation and promises align with the experiences it delivers. The approach emphasizes brand trust, recognizing that trust is built through every interaction and every impression. When expectations and experiences align, organizations are better positioned to build lasting relationships with the people they serve. In healthcare, that connection is especially important. Choosing coverage, understanding benefits, comparing options, and accessing care can be challenging. Health plans that provide clear information, meaningful support, affordability, and easier navigation can help people make more confident decisions about their healthcare and well-being. Making healthcare easier A strong brand is ultimately defined by the experience it delivers. For Blue Shield, that means bringing its mission of healthcare worthy of family and friends to life through innovative products, personalized support, and resources designed to help members navigate care more easily. Investments in digital tools, service models, transparency, and affordability are aimed at reducing complexity and helping people make more informed healthcare decisions. Together, these efforts strengthen the connection between what Blue Shield promises and what members experience. For consumers evaluating health plans during open enrollment, that connection matters. Choosing a health plan is one of the most important healthcare decisions people make each year, and today's consumers expect both quality coverage and a seamless, trustworthy experience. Building trust beyond the member experience Forrester's Brand Experience measure also captures perceptions among people who are familiar with a company but are not current customers. Blue Shield believes its recognition in the Leading Quadrant of the growth grid for U.S. health insurers aligns with its values and trust, and indicates that the brand is resonating beyond its existing member base. The recognition comes as Blue Shield continues to strengthen the experience it delivers across every touchpoint. That focus is also reflected in the company's new "This Is Your Shield" campaign, which positions Blue Shield as a trusted partner helping people navigate healthcare with confidence. "Creating a simpler, more supportive healthcare journey for our members is at the heart of everything we do," said Jigar Shah, chief marketing and strategy officer at Blue Shield of California. "It is an honor to be recognized among leaders in experience, and we know that we're not done yet. We will continue investing in the programs and tools that help us better serve our members and communities." Forrester does not endorse any company, product, brand, or service included in its research publications and does not advise any person to select the products or services of any company or brand based on the ratings included in such publications. Information is based on the best available resources. Opinions reflect judgment at the time and are subject to change. This report is part of a broader collection of Forrester resources, including interactive models, frameworks, tools, data, and access to analyst guidance. For more information, read about Forrester's objectivity here.

Behavioral Health Business
Sep 29th, 2026
Blue Shield of California, Magellan ghost network lawsuit continues after failed motion to dismiss.

Blue Shield of California, Magellan ghost network lawsuit continues after failed motion to dismiss. A lawsuit alleging that Blue Shield of California and Magellan Health maintained a ghost network directory of inaccurate information for mental health clinicians in its network will continue after a U.S. District Judge partially denied Blue Shield's motion to dismiss. The suit first opened in November 2025 as an Employee Retirement Income Security Act (ERISA) lawsuit, which regulates employer-sponsored benefit plans, health plans and related benefits. In the latest development, Blue Shield of California sought dismissal of all 11 claims against it, arguing that that the plaintiff parties had not tied their ghost network allegations to patient impact, concrete injury or enforceable plan promises. On Sept. 23, District Judge William H. Orrick III for the Northern District of California validated a central argument of the plaintiffs' case, which bases muchof the evidence and argument on more than just directory inaccuracies, but points to issues that bled into access-to-care challenges. "The contract between Blue Shield and plaintiffs' employers is to provide health benefits to the employees. The plaintiffs are third-party beneficiaries of the employer contracts and can enforce violations of them," Judge Orrick wrote in his Sept. 23 decision. "They do not plead that plaintiffs requested out-of-network authorization, submitted a claim or grievance and received a denial." He also noted that some causes of action were dismissed against Blue Shield because they were duplicate and "superfluous," and that "at this stage, I will draw all inferences in favor of the plaintiffs." A spokesperson for the payer told Behavioral Health Business that "Blue Shield of California does not comment on pending litigation." Questions about Magellan's role of responsibility as Blue Shield's behavioral health administrator also rose during this case, but in his Sept. 23 decision to not dismiss the case, Judge Orrick distinguished the line between delegated operations and Magellan's direct legal liability, calling out Blue Shield of California's "responsibility to monitor [Magellan's] compliance with the delegation criteria and standards." "The intended beneficiary of the contract is Blue Shield, not its members, and it is Blue Shield that will seek redress in the event the agreement is breached," Judge Orrick wrote. "Plaintiffs are not intended third-party beneficiaries to the Magellan-Blue Shield contract and may not sue for breach of its provisions." Fraud-based claims against Magellan alleging intentional negligence and misrepresentation of its behavioral health network still stand. BHB reached out to Magellan for comment, but a response has not yet been received. Plaintiffs have until Oct. 13 to file any amendments to the complaint as it stands. Following that, the case will be open to discovery, class certification and evidence testing to determine if access failures were legally actionable. If it stands as is without amendment, Blue Shield will have to face the bulk of surviving claims against it compared to Magellan, including non-ERISA breach of contract claims, intentional and negligence claims, improper denial of benefits allegations, ERISA fiduciary-duty claims and a mental health parity claim. For its part, Magellan will still face ERISA benefits and fiduciary-duty claims, along with unlawful-prong theory claims. Although Magellan may have handled day-to-day behavioral health functions, the court currently views Blue Shield as the ultimately accountable party for the insurance coverage it sold to them. This case is open, and developments are ongoing. Neither Blue Shield nor Magellan has been found liable for any allegations at this time. Moving forward to class certification is the next big step in the process, according to Sara Haviva Mark, a healthcare attorney at Mark Health Law, told Behavioral Health Business. Haviva Mark prosecutes ghost network cases, but is not directly involved in this one. "Right now, this is a small 'b' big deal, and if it reaches class certification, that will be a capital 'B' big deal," she said. "I think the biggest win is on the California UCL [Unfair Competition Law] state law claims. It's a win in itself that it survived the motion to dismiss. But those are ripe for class-wide damages." Mark Health Law is a law firm based in New York City that specializes in mental health care, health insurance and employer health care benefits. There has been an uptick over the last few years in cases brought against insurance giants for maintaining therapy ghost networks. That trend is not slowing down anytime soon; Haviva Mark said the behavioral health field can expect to see even more in the years to come. "This is the first wave," she said. "This is low-hanging fruit in my mind in the mental health space. These are just false directories and in the field we're going to have way more complicated cases over time. Hopefully, cases where we can hold insurance companies accountable for their networks will be the first step, and then that will help catalyze more change." Companies featured in this article: Ashleigh Hollowell is a professional journalist who has spent her career covering a range of local news, contributing to independent magazines and trade publications, and providing in-depth national health care reporting. Her work has appeared in Becker's Hospital Review, VentureBeat, PopSugar, MSN Singapore, and related outlets. She received her bachelor's degree from Colorado State University-Pueblo and her master's from Syracuse University. In her free time, she volunteers with local organizations, enjoys hiking, reading, and yoga. September 29, 2026 September 9, 2026 August 28, 2026

AsSIST-UK
Sep 28th, 2026
Blue Shield of California launches food as Health initiative with support for Alameda County Community Food Bank.

Blue Shield of California launches food as Health initiative with support for Alameda County Community Food Bank. * September 28, 2026 * Business Blue Shield of California September 28, 2026 Nonprofit health plan commits $600,000 for a statewide initiative; Alameda County Community Food Bank is first collaboration with $300,000 support to improve health and well-being OAKLAND, Calif., Sept. 28, 2026 /PRNewswire/ - Blue Shield of California today announced a new statewide "Food as Health" initiative that will provide $600,000 to seven California food-security nonprofits. The investments will support medically tailored meals, culturally congruent resources, family nutrition programs, and other community-based solutions that connect healthcare and nutrition to improve health outcomes and advance equitable access to care. This initiative reflects the nonprofit health plan's commitment to addressing the social drivers of health, combating chronic disease, improving access to nutritious food, and advancing long-term healthcare affordability. As the first investment under Blue Shield's new statewide Food as Health initiative, Blue Shield and Alameda County Community Food Bank (ACCFB) today announced a $300,000 multi-year investment to expand the food bank's Food as Medicine program, which provides home-delivered, medically supportive food and nutrition education to eligible Medi-Cal members managing chronic conditions. Blue Shield is the program's first and largest corporate sponsor investment, helping Alameda County Community Food Bank's pioneering Food as Medicine program to serve more people and strengthen the infrastructure, data collection, and evaluation needed to sustain and expand the program. "Nutritious food is one of the foundations of good health," said Mike Stuart, president and CEO of Blue Shield of California. "As a nonprofit health plan, we have an important role to play in helping people live healthier lives. Access to healthy food can improve health outcomes, help prevent and manage chronic conditions such as diabetes, heart disease, and hypertension, and support more affordable healthcare over the long term. We're proud to partner with Alameda County Community Food Bank to help build healthier communities and healthier futures." The announcement was made during a volunteer event at the food bank's Oakland facility, where Blue Shield employees assembled Food as Medicine boxes and welcome kits for program participants. Leaders from both organizations, community stakeholders, and participants gathered to celebrate the program's impact and the role of nutrition in improving health outcomes. Food as Medicine participants receive 12 weeks of home-delivered, medically supportive food, including fresh produce, proteins, healthy pantry staples, and nutrition education. Developed from a successful diabetes prevention pilot, the program expanded to support people with chronic conditions and became the first food bank in California to leverage funding from California Advancing and Innovating Medi-Cal (CalAIM) to provide medically supportive food to eligible Medi-Cal members. Since 2024, the program has grown from an initial cohort of 20 participants to serving more than 400 people annually, reflecting growing demand for nutrition-based approaches that complement traditional medical care. "Serving as a food justice organization means pushing the boundaries of what it means to be a food bank," said Regi Young, executive director of Alameda County Community Food Bank. "Food insecurity is one part of a complex picture impacting our community - and our Food as Medicine program addresses the intersection between our core work and healthcare. As our first and largest corporate sponsor for the program, Blue Shield's investment will expand our existing model and be a catalyst to share this model with other partners, potentially reshaping how chronic disease is addressed in the future." The Alameda County Community Food Bank investment is the first of seven investments that will be awarded through Blue Shield's Food as Health initiative. Additional investments supporting food-security organizations across California will be announced in the coming months. About Blue Shield of California Blue Shield of California strives to create a healthcare system worthy of its family and friends that is sustainably affordable. The health plan is a taxpaying, nonprofit, independent member of the Blue Shield Association with nearly 6 million members, 6,800 employees, and more than $28 billion in annual revenue. Founded in 1939 in San Francisco and now headquartered in Oakland, Blue Shield of California and its affiliates provide health, dental, vision, Medicaid, and Medicare healthcare service plans in California. The company has contributed more than $60 million to the Blue Shield of California Foundation in the last three years to have an impact on California communities. For more news about Blue Shield of California, please visit news.blueshieldca.com. Or follow assist-uk on LinkedIn or Facebook. About Alameda County Community Food Bank Alameda County Community Food Bank has been at the forefront of hunger relief efforts in the Bay Area since 1985. The Food Bank serves a community in which 1 in 4 residents experiences some level of food insecurity. The Food Bank's core work includes distributing food through a network of more than 350 food pantries, meal programs, and other community organizations, as well as direct distribution programs including school-based and home delivery distributions. The Food Bank annually distributes the equivalent of ~50 million meals worth of food. In addition to its extensive emergency food programming, ACCFB's hunger-relief efforts include California's largest CalFresh (Supplemental Nutrition Assistance Program) outreach department, anti-hunger advocacy, food as medicine, and food recovery and sustainability efforts. Alameda County Community Food Bank was named Feeding America's Food Bank of the Year in 2016; is an accredited charity by the Better Business Bureau; and for 17 consecutive years has received a Four Star rating from Charity Navigator. SOURCE Blue Shield of California Distributed by PR Newswire / Cision.

TrueCare
Sep 22nd, 2026
Join TrueCare's Monster Mash Wellness Bash in Oceanside on oct. 23.

Join TrueCare's Monster Mash Wellness Bash in Oceanside on oct. 23. Date: friday, october 23, 2026. Time: 4:00pm - 7:00pm. Location: john landes community center. 2855 Cedar Rd, Oceanside, CA 92056 Get Directions Celebrate Halloween with all treats and no tricks at TrueCare's family-friendly Monster Mash Wellness Bash. The event is sponsored by Blue Shield of California Promise in partnership with the City of Oceanside Housing & Neighborhood Services and Oceanside Unified School District. Families can enjoy substance use prevention education, Halloween safety information and activities including: * Kids' costume contest * Crafts and interactive activities * Giveaways and raffle prizes * DJ * Food Teams from Mission Mesa Pediatrics, Vista Way Dental, Mission Mesa Women's Health, Behavioral Health and WIC will also be on-site with health and enrollment services, including: * Medical and dental screenings and flu vaccines through the Boo Mobile * Height and weight checks for children * Help from Enrollment Services specialists who can answer questions about Medi-Cal eligibility, applications and renewals

Vialynx Inc
Sep 15th, 2026
Point32Health appoints Todd Walthall to board of directors.

Point32Health appoints Todd Walthall to board of directors. Sports · SEP 15, 2026 PR Newswire CANTON, Mass., Sept. 15, 2026 /PRNewswire/ - Point32Health, the parent company of Harvard Pilgrim Health Care and Tufts Health Plan, today announced th... CANTON, Mass., Sept. 15, 2026 /PRNewswire/ - Point32Health, the parent company of Harvard Pilgrim Health Care and Tufts Health Plan, today announced the appointment of Todd Walthall, an accomplished health care executive, to its board of directors. Walthall brings more than two decades of executive leadership experience across some of the nation's leading health care, financial services, and insurance organizations. He previously served as chief growth officer at Optum Health, a leading health solutions and care delivery organization, after leading Payer Markets at Optum Insight and serving as executive vice president of Enterprise Growth at UnitedHealth Group. "Todd is an accomplished health care executive whose experience spans care delivery, health innovation, business growth, and operational leadership," said Eileen Auen, executive chair, Point32Health board of directors. "His deep understanding of the health care ecosystem and proven ability to drive transformative growth will be invaluable as we continue advancing our purpose and delivering greater value for our members, customers, and the communities we serve. We are delighted to welcome Todd to the board." Prior to joining Optum, Walthall served as executive vice president and chief operating officer at Blue Shield of California, leading business operations, technology, and strategic initiatives across the plan's commercial, individual, and government lines of business. Walthall currently serves as an independent board director of AllianceBernstein (NYSE: AB) and as a board trustee of the Positive Coaching Alliance. Earlier in his career, he held senior leadership positions at American Express and USAA. Walthall earned a bachelor of science degree in business administration from Emmanuel College. About Point32Health Point32Health, the parent company of Harvard Pilgrim Health Care and Tufts Health Plan, is a leading nonprofit health and well-being organization dedicated to delivering high-quality, affordable health care. Serving nearly 2 million members, our purpose is to guide and empower healthier lives. SOURCE Point32Health Published by News Desk · WeeklyReviewer The WeeklyReviewer news desk monitors breaking developments around the clock - sourcing, verifying, and publishing real-time industry news across business, technology, politics, science, sports, and world affairs. Every story that comes through the Live Wire is reviewed for accuracy before publication, keeping our readers ahead of the curve without the noise.