Department of Social and Health Services (DSHS), Home & Community Living Administration (HCLA), the division of Home & Community Services (HCS) is seeking a Critical Incident Program Manager. The Home and Community Services (HCS) Division promotes plans, develops and provides long-term care services for people with disabilities and the elderly.
In 2024, The Centers for Medicare & Medicaid Services (CMS) established new federal requirements – CMS Access Rule – designed to improve transparency and accountability, standardize data and monitoring and create opportunities for states to promote active beneficiary engagement in their Medicaid programs with the goal of improving holistic access to care, and quality of care, and improving health outcomes for Medicaid beneficiaries across fee-for-service (FFS) and managed care delivery systems, including home-and community-based services (HCBS) provided through those delivery systems.
Under the 2024 CMS Access Rule, states must meet nationwide incident management system standards for monitoring HCBS programs, including critical incident reporting. This requires DSHS to develop and implement an Incident Management System and an Electronic Critical Incident System.
As a Critical Incident Program Manager, you will be responsible for developing and deploying key deliverables tied directly to the Critical Incident requirements in the Centers for Medicare & Medicaid Services (CMS) Access Rule. You will provide expert-level counsel, analysis, facilitation, coordination, partnering, rule writing, decision package development, and negotiations. You will develop, implement, and maintain the HCS Critical Incident program and the continuous quality improvement (CQI) function built around it, to improve the safety, consistency, and overall quality of Medicaid-funded long-term services and support delivered to HCS clients.
This is a project-based position with current funding through the 2025-2027 biennium. This position offers a flexible hybrid schedule, allowing employee to work remotely from anywhere in Washington. The official work location is Olympia, and occasional in-person meetings at the Olympia headquarters may be required based on business needs.
Some of what you’ll do:
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Design, operate and administer the HCS Incident Reporting and Management System.
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Develop the HCS framework for incident reporting, triage, escalation, incident reviews, coordination, resolution, and quality monitoring to support improved outcomes for people served by HCS and the Area Agencies on Aging (AAA), Washington’s long-term care partners.
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Develop and maintain project timelines, decision logs, and risk registers; align interdivisional deliverables so that Washington meets CMS Access Rule Critical Incident requirements, including timelines and performance expectations.
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Routinely review signals of possible critical incidents that arrive outside the standard provider/case manager reporting workflow, including (without limitation) grievances filed through the HCLA-wide grievance system
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Report findings, response status, and emerging risks to HCS leadership on a regular cycle, and escalates matters involving imminent client safety, legal exposure, or media or legislative interest.
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Represent HCS on the enterprise-wide CMS Access Rule Critical Incident Work Group across HCLA and DDA in service of HCS Critical Incident program objectives.
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Drive HCS provider and Area Agency on Aging (AAA) quality improvement through policy, contract, partnership, and technical assistance.
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Integrate HCS incident data with the HCLA-wide grievance system and support HCS continuous quality improvement.
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Establish and maintain non-duplicative data-sharing arrangements with APS, RCS, and other partner agencies in service of HCS Critical Incident work.
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Engage HCS external stakeholders and ensure HCS federal compliance and audit readiness.
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Coordinates with tribal nations in accordance with the DSHS tribal consultation policy regarding HCS critical incident work.
Who should apply:
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A bachelor’s degree in public health, social work, public administration, health administration, public policy, data analytics, or a closely related field AND five or more years of progressively responsible professional experience in critical incident management, quality improvement, health or human services program management, or a related field.
OR
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Equivalent combination of education and/or professional experience.
Knowledge of:
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Medicaid home and community-based services (HCBS) and long-term services and supports, including applicable federal and state statutes and regulations.
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CMS Access Rule, HCBS Final Settings Rule, and HCBS Quality Measure Set, including the eight federally required Critical Incident deliverables.
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Critical incident management, grievance, and continuous quality improvement systems in large human services organizations.
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Data governance, HIPAA, and state confidentiality requirements.
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Washington's long-term services and supports delivery system, including the roles of HCS, AAAs, DDA, APS, RCS, HCLA OAS, HCA, and the Office of the Long-Term Care Ombuds.
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Program and project management tools, as well as continuous improvement, change management and evaluation tools and other methods.
Skills
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Lead and facilitate work groups across different agencies and teams, even when you do not have direct authority.
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Analyze data to identify trends, causes of problems, and areas for improvement.
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Write clear policies, procedures, contracts, and other documents.
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Communicate clearly with clients, providers, agencies, executives, legislators, and other stakeholders.
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Negotiate data-sharing agreements and Memorandums of Understanding (MOUs).
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Work effectively in a political environment with state and local officials, agencies, tribal leaders, local governments, community organizations, and advocacy groups.
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Coordinate projects and work across teams without direct supervisory authority.
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Assess how changes to policies, procedures, and laws may affect agency goals and services.
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Manage projects from planning through implementation, including schedules, assignments, risks, issues, and communication.
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Research complex or sensitive issues and provide recommendations to executive leadership.
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Use Microsoft Office programs effectively.
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Keep the needs of HCS and its clients as the focus while working across the organization.
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Prepare clear written correspondence and communicate effectively both verbally and in writing.
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Lead through collaboration and influence when authority is shared or limited.
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Use critical thinking to understand complex information and explain it clearly to different audiences.
Preferred / desired education, experience and competencies:
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Master's degree in a relevant field (MPH, MSW, MPA, MHA, or similar).
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Direct experience with Medicaid HCBS programs or long-term services and support.
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Experience reviewing and actioning critical incidents identified through non-standard channels (grievances, protective-services data, licensing surveys, claims data, law enforcement, advocacy referrals).
Completed applications will include
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A letter of interest (up to two pages) specifically addressing the knowledge, skills, and experience you have related to the job and duties.
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A current, chronological resume.
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A minimum of three professional references with contact information.
If you have questions about the job posting number 06295, contact Anu Rao email at [email protected].
The Department of Social and Health Services’ (DSHS) vision that people find human services to shape their own lives requires that we come together with a sense of belonging, common purpose, shared values, and meaningful work. It is crucial to our agency’s vision that you bring fairness, access, and social justice commitment to your work with DSHS. We strive to support all Washingtonians, including Black, Indigenous, and People of Color, people with physical, behavioral health, and intellectual disabilities, elders, LGBTQIA+ individuals, immigrants and refugees, and families building financial security.
Prior to a new hire, a background check including criminal record history may be conducted. Information from the background check will not necessarily preclude employment but will be considered in determining the applicant's suitability and competence to perform in the job. This announcement may be used to fill multiple vacancies. Employees driving on state business must have a valid driver's license. Employees driving a privately owned vehicle on state business must have liability insurance on the privately owned vehicle.
Washington State Department of Social and Health Services is an equal opportunity employer and does not discriminate in any area of employment, its programs or services on the basis of age, sex, sexual orientation, gender, gender identity/expression, marital status, race, creed, color, national origin, religion or beliefs, political affiliation, military status, honorably discharged veteran, Vietnam Era, recently separated or other protected veteran status, the presence of any sensory, mental, physical disability or the use of a trained dog guide or service animal by a person with a disability, equal pay or genetic information. Persons requiring accommodation in the application process or this job announcement in an alternative format may contact the Recruiter at (360) 725-5810. Applicants who are deaf or hard of hearing may call through Washington Relay Service by dialing 7-1-1 or 1-800-833-6384.
Relationship and Reporting Structure (Nepotism) Disclosure: If you are selected for hire, you must disclose whether you have a relative, household member, close friend, or romantic partner within your potential supervisory chain of command. DSHS has a Relationships and the Reporting Structure policy that prohibits nepotism and can be reviewed here (Download PDF reader)(Download PDF reader)(Download PDF reader). Applicants whose appointment would result in a prohibited reporting relationship are not eligible for appointment to that position.
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