Compliance Manager

at  Cedar Lake

WHO WE ARE:

Unconditional love for people with disabilities – this is the heart of who we are and whom we employ at Cedar Lake. We are the largest private provider of residential and community-based services for adults with intellectual and developmental disabilities (IDD) in the state of Kentucky. We are a local non-profit organization founded in 1970 by Louisville-area parents of people with IDD. We believe that a well-trained staff, committed to the mission and vision of Cedar Lake, will successfully offer a high level of compassionate, capable care, responsive to the needs of the mind, body, and the spirit of the people we serve. We are seeking qualified individuals who are determined to share meaningful interactions that cultivate mutual respect and unconditional love to those with intellectual and developmental disabilities. Our employees are the cornerstone of all that we do, and our team provides friendly and regular support to our staff of over 450 people.

WHAT YOUR TYPICAL SCHEDULE LOOKS LIKE:

• Full-time schedule, 40 hours per week. Responsibilities may occasionally include extended hours or weekends as needed.
  If this sounds like the move you’ve been looking for, apply on this posting or visit www.cedarlake.org/career.
  We are an equal opportunity employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, national origin, disability, status, protected veteran status, sexual orientation, gender identity, or any other characteristic protected by law

This role is responsible for the overall regulatory compliance for Cedar Lake Residences. This role must function as a member of the Cedar Lake team and as such may provide supplementary assistance to any individual served by the organization.

• Maintain knowledge of eligibility and service regulations related to all Medicaid Waivers. Assume a primary role in fostering and maintaining relationships with Quality Administrators and other state employees.
• Facilitate annual state waiver reviews; in conjunction with the Executive Director, coordinate response and plan of correction, if appropriate. Develops and monitors quality improvement plans.
• Communicate on a regular basis with external case managers and monitors activities to ensure that prior authorizations reflect all services provided by Cedar Lake and that all required documentation is current and included in individual records to maximize reimbursement.
• Pull prior authorizations (PAs) from the state website and routes to appropriate individuals following designated procedures. Facilitate communication between outside case managers and CLR management and direct care staff.
• Provide CLR representation and coordinates with regional Human Rights Committee and Behavior Intervention Committee. Attend internal Services Committee required by group home licensure. Coordinate internal Risk Management team, review, and monitor incident reports. Attend quarterly provider meetings and scheduled coalition meetings.
• Update demographics in individual electronic records and upload pertinent documents as required. Audit and update records for all state and federal program reviews.
• In conjunction with the Executive Director and Human Resources, ensure documentation of mandatory training requirements and ensure compliance with personnel documentation.
• Coordinate with the billing office and ensure compliance with requirements to ensure appropriate reimbursement. Ensure all forms of regulatory and licensing standards are met.
• Must have working knowledge of compliance software- i.e., Oasis, MWMA, etc. as well as state and federal regulations related to all waiver systems and requirements.
• Monitor all new admission records to ensure regulatory compliance.
• Perform other duties as assigned.