Rural Health Transformation Senior Financial Manager; WMS​/FS - Project

Rural Health Transformation Senior Financial Manager (WMS/FS) - Project

This is a project position funded through 09/30/2030.

The Rural Health Transformation Senior Financial Manager has a core strategic and tactical role in the administration of Washington’s Rural Health Transformation (RHT) initiatives. The RHT initiatives comes from the H.R.1 budget reconciliation bill, which Congress passed in 2025. Administered by Centers for Medicare and Medicaid Services (CMS), the RHT initiatives help the states build robust health systems through funding for technology, workforce recruitment, and new care delivery methods.

The RHT initiatives could provide Washington State with up to $1 billion in funding over a five-year period. These funds are intended to:

• Strengthen state’s rural healthcare infrastructure
• Improve healthcare access, quality, and sustainability
• Address health care workforce shortages
• Promote innovative care models
• Provide support for rural providers facing financial challenges

All HCA employees will apply an equity lens to their work, which may include but is not limited to all analyses of core business and processes.

The Financial Services Division (FSD), in collaboration with other Health Care Authority divisions and a variety of external stakeholders and legislative partners, provides strategic financial expertise for Apple Health, Community Behavioral Health, PEBB and SEBB programs. In addition, FSD oversees the budget and compliance functions necessary to manage and monitor the single largest Washington state individual operating budget. Functions include budget management, accounting, forecasting, professional and hospital rate setting, financial analysis, and payment/collection operations.

This division maintains a close working relationship with agency program, policy, and clinical divisions to ensure financially sound implementation and monitoring of program strategies. It is also accountable to the Governor and legislature in ensuring HCA operates within its budget.

The Senior Financial Manager is the primary point of contact for all fiscal matters related to the RHT initiatives and the projects grant offered through the federal CMS. This position directly manages two RHT Financial Analysts and is the state’s lead fiscal representative for this initiative / project. The Senior Financial Manager reports to the Waiver and Demonstration Finance section manager within FSD.

This position is eligible to telework but is required to report on‑site 2 days a week to meet business need. The default assigned work location of all Health Care Authority (HCA) positions – both on‑site and telework eligible positions – is within the State of Washington. This position reports to Olympia, WA. Frequency of on‑site work will vary based on business and operational needs.

HCA has currently suspended the ability to support out‑of‑state telework.

• Manage and oversee the development of the RHT annual budget, including creation of the chart of accounts, budget allotments and decision package requests.
• Work closely with other fiscal and policy staff (including outside agencies and external staff) and provide clear direction, conflict resolution, oversight, consultation, and analysis to others regarding fiscal matters.
• Directly manage two (2) fiscal positions, including planning and assigning work, leading and mentoring staff. This also includes performing staff annual performance evaluations and setting expectations.
• Manage and oversee the development and production of all internal and federally required RHT financial reports.
• Oversee all RHT financial analyses, answer fiscal inquiries from internal and external staff, including explaining program expenditure or revenue trends.
• Oversee the fiscal communication and coordination with HCA executive leadership, policy staff, legislative and elected members, governor’s office, outside agencies, program contractors and sub‑grantees.
• Manage multiple high‑priority assignments, resolve complex problems often having material political and financial implications.

Qualify…