DSHS HCLA Critical Incident Program Manager

Description

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  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.

• Design, operate and administer the HCS Incident Reporting and Management System.
• 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.
• 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.
• 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.
• 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.
• 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.
• Drive HCS provider and Area Agency on Aging (AAA) quality improvement through policy, contract, partnership, and technical assistance.
• Integrate HCS incident data with the HCLA-wide grievance system and support HCS continuous quality improvement.
• Establish and maintain non-duplicative data-sharing arrangements with APS, RCS, and other partner agencies in service of HCS Critical Incident work.
• Engage HCS external stakeholders and ensure HCS federal compliance and audit readiness.
• Coordinates with tribal nations in accordance with the DSHS tribal consultation policy regarding HCS critical incident work.

• A bachelor’s degree in public health, social work, public administration, health administration, public policy, data analytics, or a closely related…