Sentinel Event Program Manager (HQ)

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Company: State of Washington

Location: Tumwater, WA 98511

Description:

Salary: $10,456.00 - $11,876.00 Monthly
Location : Thurston County - Tumwater, WA
Job Type: Full Time - Permanent
Job Number: HS-HQ-2025-01670
Department: Dept. of Corrections
Division: HS - HQ
Opening Date: 03/04/2025
Closing Date: 3/10/2025 11:59 PM Pacific

Description
Sentinel Event Program Manager

Walla Walla, WA

Schedule: Mon. - Fri. 8am - 5pm

Annual Salary Range: $125,472 - $142,512
The Sentinel Event Program Manager reports to the Health Service Division's Director of Quality.

The Sentinel Event Program Manager responsibilities:

Responsible for the management, operation, and coordination of assignment deliverables of the Department's Care Review Appeals, Mortality Review and Unexpected Fatality Review Committees.
Designated as the Department's lead for managing how these committees operate, ensuring that all case presentations have been sufficiently/accurately researched and that relevant subject matter experts from Department of Corrections (DOC), Department of Health (DOH), Office of the Corrections Ombuds (OCO) and Health Care Authority (HCA) are represented when needed at any one of these committee meetings.
Supervises a Sentinel Event Review Specialist and works directly with members assigned to these committees to review the circumstances and records of each individual's fatality or care review appeal. Committee members are responsible to explore the root causes that contributed to findings and to propose recommendations for corrective action to prevent future fatalities and strengthen the safety and health protections of persons in the custody of the department.
Ensures that committee and corrective action reports are completed, reviewed, approved, and issued to the Governor's office, legislature and posted to the Department's public facing website within required timelines.

Application assessment will be ongoing, and the hiring authority reserves the right to offer the position at any time during the recruitment process. It is to the applicant's advantage to apply as early as possible.
"This recruitment could be used to fill multiple permanent or non-permanent positions."
Duties
Mortality Review Committee (MRC)

Designated as Department lead responsible for operation, management, and facilitation of the Department's Mortality Review Committee.
Ensures that Department's Mortality Review Committee (MRC) completes a multidisciplinary mortality case review for every incarcerated individual whose fatality occurred while in Department custody within 60 days from the date of fatality.
Schedules, organizes, and convenes a weekly mortality review committee attended by medical, behavioral/mental health, nursing, pharmacy, dental and reentry providers to conduct a post-mortem review of an incarcerated individual's medical care to explore root causes and identify interventions to prevent future fatalities.
When it is unclear what may have caused a finding, ensures that a root cause analysis is assigned and completed within 60 days of the date of fatality to inform what corrective actions should be taken to mitigate the risk that a finding will occur again.
Compiles, reviews, and prepares medical records received and assigns medical professionals who are responsible to review these records and present the case to members of the mortality review committee.
Contacts county medical examiners, hospitals, and community jails to obtain copies of medical records (i.e., assessments, autopsy results, death certificate, toxicology reports, etc.) for use in conducting the Department's mortality reviews.
Ensures that all MRC members have a signed confidentiality statement on record and that these are updated at least annually.
Reviews and tracks the status of previously assigned action items to ensure completion.
Ensures that Mortality Review Committee Teams' and SharePoint sites contain all records and notes used in the Committee's review and that records are secure and available should Department be required to give an account regarding findings and the completion status of MRC adopted action items to correct findings.
Reviews and updates MRC charter at least annually to ensure that information contained within is current.
Refers cases reviewed by MRC to Unexpected Fatality Review (UFR) committee within 60 days from the date of fatality when MRC committee determines that the fatality meets criteria as an
"Unexpected" fatality per RCW 72.09.770.
Trains and orients MRC members regarding committee processes, responsibilities, and expectations.

Unexpected Fatality Review (UFR) Committee

Ensures that the UFR Committee conducts an unexpected fatality review in any case in which the fatality of an incarcerated individual is unexpected, or in any case identified by the Office of the Corrections Ombuds for review.
Designated as the Department's lead responsible for the operation, management, and facilitation of the Department's Unexpected Fatality Review Committee.
Prior to UFR Committee meeting, this position is responsible to review the MRC report, Critical Incident or Administrative Review Report, and capture any recommendation directly related to the fatality.
Develops case presentation for each fatality that UFR Committee Members are to review. UFR case presentations typically include the following information: Incarceration history summary, personal goals, personal interests, relationships/family, timeline of events leading up to the individual's fatality, summary of critical incident reports findings and recommendations, summary of medical record review, summary of findings and recommendations from the completed mortality review.
Ensures that UFR case presentations are posted to the secure UFR Committee Team site at least 2 weeks prior to the UFR Committee meeting. This allows committee members time to review and prepare questions and recommendations prior to the meeting. If records are not available, communicates with committee
members to provide information about why there is a delay.
Responsible for documenting questions, information shared, and recommendations proposed by UFR Committee members and ensures that this information is included in the UFR Committee's final report.
Responsible to DRAFT UFR Committee and Corrective Action Reports and to send to UFR Committee members for review and approval before sending to DOC Secretary and Deputy Secretary for final review and approval before sending to the Governor, WA State Legislature, and posting on DOC's public facing website.
Ensures that UFR Committee reports are published within 120 days from the date of the unexpected fatality.
Ensures that UFR Committee Corrective Action Plan (CAP) reports are published within 130 days from the date of the fatality.
Ensures that Items identified for corrective action in the UFR Committee CAP report are completed within 120 days from the date that the CAP report is published.
Ensures that CAP Tracking Database on UFR Team site is current and up to date with information regarding the completion status of CAP items.
When there are delays in obtaining medical records, death certificates and autopsy results, initiates formal extension request to HS Assistant Secretary.
Produces and presents UFR Outcomes report to Health Services Administrative Services Board annually.
Functions as UFR Committee's liaison to other State Agencies and Department Divisions.
Train and orient UFR committee members regarding committee processes, responsibilities, and expectations.

Care Review Committee - Appeals

Designated as Department lead responsible for operation, management, and facilitation of the Department's Care Review Appeal Committee.
Ensures that Department's Care Review Appeal Committee completes a review for every incarcerated individual who appeals a care review committee (CRC) decision within 30 days from the date of the appeal.
Schedules, organizes, and convenes a monthly appeal committee attended by physicians and/or dentists who were not involved in the previous CRC decision.
Compiles, reviews, and prepares medical records received, produces a care summary, and assigns medical professionals who are responsible to review these records and prior to making a decision regarding the appeal request.
Ensures that Care Review Appeal Committee's Teams and SharePoint sites contain all records and notes used in the Committee's review and that records are secure and available should Department be required to give an account regarding findings and the completion status.
Produces and distributes notification of Committee decisions to the patient, HSM and primary care provider.
Produces and presents Care Review Appeals Outcomes report to Health Services Administrative Services Board annually.

Policy Management

Designated as policy owner of DOC 620.200 "Death of Incarcerated Individuals" who is responsible to ensure that policy standards are clear and achievable. Ensures that a formal policy review is completed annually.

Other

Provides support to DOC's clinical leads in their review of medical records to prepare for public disclosure requests, depositions, and legislative testimony related to fatalities and care review appeals.
Conducts legislative bill analyses within 48 hours of assignment, during legislative session, to determine impacts to the Department if bill were to be adopted by the legislature.
Demonstrate professionalism and DOC values in all aspects of work.
Provides support to other HS and/or DOC efforts as directed.
Assists with Adverse Event external reporting and Root Cause Analysis (RCA) projects as assigned.

Qualifications
Required Qualifications:

A minimum of seven (7) years directly relevant experience is required in leading and/or managing high visibility and high-impact programs and/or processes,

AND

A minimum of three (3) years of professional experience with working with appointed and elected government executives, legislative bodies and community stakeholder groups.
Knowledge of and ability to apply principles, practices and methods of systems thinking and change Knowledge of and ability to apply quantitative and qualitative research methods
Knowledge of and ability to apply Lean principles, practices and methods.
Knowledge of and ability to apply change management principles, practices and methods
Knowledge of and ability to apply advanced facilitation techniques Ability to recognize, detect, and resolve complex operational issues.
Ability to create and maintain good working relationships through excellent communication and team building skills, including the ability to engage successfully with both internal and external stakeholders.
Exceptional communication skills, both verbal and written, including the ability to prepare and deliver clear and concise presentations, reports and data visuals/dashboards.
A professional level of expertise in multiple areas of large-scale and complex operations and demonstrated use of high-level discretion and judgement in execution of duties.
Ability to maintain strict confidentiality and handle difficult situations with diplomacy, tact and empathy. Ability to manage and maintain simultaneous, transitional, and emerging priorities.
Ability to advance DOC values, including Equity, Diversity, Inclusion and Respect.

Preferred Qualifications

A Bachelor's Degree from an accredited college or university whose accreditation is recognized by the U.S. Department of Education and the Counsel for Higher Education (CHEA) in health care, social sciences, or business management.

Supplemental Information

Mission: The mission of DOC is to improve public safety by positively changing lives.
Our Vision: Working together for safer communities.
Our Commitment: To operate a safe and humane corrections system and partner with others to transform lives for a better Washington.
Our Core Values:
Cultivate an environment of integrity and trust: Corrections values partnership and trust. We foster openness and support courageous conversations. We are committed to doing what we say we are going to do by being accountable and taking personal ownership in our actions.
Respectful and inclusive interactions: Corrections appreciates and values individuals by promoting an inclusive and diverse environment, which encourages safety. We respect, value, and listen to the thoughts, feelings, and perspectives of our stakeholders and consider the impact on those we serve as well as each other.
People's safety: Corrections believes in creating an environment that values physical, mental, and emotional security and well-being. We honor those who advance safety for all.
Positivity in words and actions: At Corrections, we assume positive intentions and believe there is a shared desire for the best outcome. We consistently demonstrate positive behavior and always put forth our best effort.
Supporting people's success: Corrections is committed to our community - understanding individuals, instilling hope, embracing change, and providing opportunities.

Important Notes or Additional Information

Please include a minimum of three (3) professional references with your application. A professional reference is defined as an individual who has been paid to supervise your work and can attest to your work performance, technical skills, and job competencies. If you do not have any or sufficient professional references, please include non-related professionals, such as educators or other professional associates.

**Please note: Phone number AND email address are required for all professional references.

The mission of DOC is to improve public safety. For additional information about the agency, please visit doc.wa.gov.

A background check including criminal record history will be conducted prior to a new hire. 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 position.
Employees may work directly with or near incarcerated individuals in a potentially hazardous setting. Please consider this when deciding whether to apply.
We are committed to maintaining a drug and alcohol-free work environment, and our employees are expected to comply with all state and federal laws. A pre-employment drug test may be administered as part of the selection process, and applicants who test positive for any controlled substances, will be disqualified from consideration.
Oleoresin Capsicum (OC) is an aerosol pepper spray made available as a means of self-defense and/or de-escalation. Applicants with sensitivities or allergies are encouraged to ask about the level of exposure they could expect in this position.
Animal care projects are a common component of most Washington State prisons, including dog and cat programs. Applicants with animal sensitivities or allergies are encouraged to ask about the level of exposure they could expect in this position.
Tuberculosis (TB) is a priority health issue for DOC employees. The successful candidate may be required to provide valid proof of a baseline TB skin test within 60 days from the date ofhire. When positive tests result, further information, testing and treatment will also be required. Employment is not contingent upon test results.
This position may be represented by a bargaining unit.

Requires respirator medical evaluation questionnaire, fit testing, training, and use of respiratory protection as required by the WA Industrial Safety & Act standards. Refer to WAC 296-842 to learn more.
Must be able to work in spaces, climb stairs, walk long distances, and frequently lift up to 30 pounds. Under rare circumstances this position may be required to lift or carry up to 50 pounds and push up to 100 pounds.
Foreign equivalent degrees awarded outside the United States must have a credential evaluation report attached to your application. You may request the required evaluation/documentation from and Until this documentation is provided, you will not be selected to move forward in the hiring process.
Candidates who are offered a job with the Department of Corrections must possess work authorization that does not require sponsorship by the employer for a visa now or in the future.
(FOR RN POSITIONS) Salary is based on experience and is determined at the time a final offer of employment is made. The salary range listed in the job posting includes Steps A-U. Step U is a longevity step and is typically gained six years after being assigned to Step T in your permanent salary range.
(FOR ALL OTHER NON WMS POSITIONS) Salary is based on experience and is determined at the time a final offer of employment is made. The salary range listed in the job posting includes Steps A-M. Step M is a longevity step and is typically gained six years after being assigned to Step L in your permanent salary range.
DOC complies with the employment eligibility verification requirements for the federal employment eligibility verification form I-9. The selected candidate must be able to provide proof of identity and eligibility to work in the United States consistent with the requirements of that form.
DOC does not use E-Verify; therefore, we are not eligible to extend STEM-Optional Practice Training (OPT). For information, please visit www.uscis.gov.

We are committed to hiring individuals who possess core diversity competencies:

Foster a positive attitude and openness toward the ever changing social and cultural makeup of the workplace.

Work effectively with people of different perspectives, abilities, disabilities, races, religions, ages, lifestyle preferences and social, ethnic and cultural backgrounds.
Respectfully acknowledge people's differences and recognize these differences as important and valuable.
Promote inclusiveness.
Be culturally sensitive and appropriate.
Respect and value diverse backgrounds and traditions.

What We Offer:
As an employee of the Department of Corrections, your work-life integration is a priority. Washington State employees are offered one of the most inclusive and competitive benefits packages in the nation. Besides comprehensive family insurance for medical, dental, and vision, these perks also may include:

Salary is based on experience and is determined at the time a final offer of employment is made. The salary range listed in the job posting includes Steps A-M. Step M is a longevity step and is typically gained six years after being assigned to Step L in your permanent salary range.

Up to 25 paid vacations days a year
8 hours of paid sick leave per month
12 paid holidays a year
Generous retirement plan
Flex Spending Accounts
Dependent Care Assistance
Deferred Compensation and so much more!

Many DOC jobs are covered by the Public Safety Employees' Retirement System (PSERS). If someone moves from a Public Employees Retirement System (PERS) eligible position to a PSERS eligible position, they actually retire under two different systems/plans. For more information, please contact the Department of Retirement System at: 1-800-547-6657.

DOC is an equal opportunity employer and does not discriminate on the basis of race, creed, color, national origin, sex, marital status, sexual orientation, gender identity, gender expression, age, honorably discharged veteran, veteran status, genetic information, or the presence of any sensory, mental or physical disability or the use of a trained guide dog or service animal by a person with a disability.
For questions about this recruitment, or to request reasonable accommodation in the application process, please emailkathey.waggoner@doc1.wa.gov or call at (509) 907-7808.

For TTY service, please call the Washington Relay Service at 7-1-1 or 1-800-833-6388.
More than Just a Paycheck!
Employee benefits are not just about the kind of services you get, they are also about how much you may have to pay out of pocket. Washington State offers one of the most competitive benefits packages in the nation.

We understand that your life revolves around more than just your career. Like everyone, your first priority is ensuring that you and your family will maintain health and financial security. That's why choice is a key component of our benefits package. We have a selection of health and retirement plans, paid leave, staff training and other compensation benefits that you can mix and match to meet your current and future needs.

Read about our benefits:
The following information describes typical benefits available for full-time employees who are expected to work more than six months. Actual benefits may vary by appointment type or be prorated for other than full-time work (e.g. part-time); view the job posting for benefits details for job types other than full-time.

Note: If the position offers benefits which differ from the following, the job posting should include the specific benefits.

Insurance Benefits
Employees and their families are covered by medical (including vision), dental and basic life insurance. There are multiple medical plans with affordable monthly premiums that offer coverage throughout the state.

Staff are eligible to enroll each year in a medical flexible spending account which enables them to use tax-deferred dollars toward their health care expenses. Employees are also covered by basic life and long-term disability insurance, with the option to purchase additional coverage amounts.

To view premium rates, coverage choice in your area and how to enroll, please visit the Public Employees Benefits Board (PEBB) website. The Washington Wellness program from the Health Care Authority works with PEBB to support our workplace wellness programs.

Dependent care assistance allows the employee to save pre-tax dollars for a child or elder care expenses.

Other insurance coverage for auto, boat, home, and renter insurance is available through payroll deduction.

The Washington State Employee Assistance Program promotes the health and well-being of employees.

Retirement and Deferred Compensation
State Employees are members of the Washington Public Employees' Retirement System (PERS). New employees have the option of two employer contributed retirement programs. For additional information, check out the Department of Retirement Systems' web site.

Employees also have the ability to participate in the Deferred Compensation Program (DCP). This is a supplemental retirement savings program (similar to an IRA) that allows you control over the amount of pre-tax salary dollars you defer as well as the flexibility to choose between multiple investment options.

Social Security
All state employees are covered by the federal Social Security and Medicare systems. The state and the employee pay an equal amount into the system.

Public Service Loan Forgiveness
If you are employed by a government or not-for-profit organization, and meet the qualifying criteria, you may be eligible to receive student loan forgiveness under the Public Service Loan Forgiveness Program.

Holidays
Full-time and part-time employees are entitled to paid holidays and one paid personal holiday per calendar year.

Note: Employees who are members of certain Unions may be entitled to additional personal leave day(s), please refer to position specific Collective Bargaining Agreements for more information.

Full-time employees who work full monthly schedules qualify for holiday compensation if they are employed before the holiday and are in pay status for at least 80 nonovertime hours during the month of the holiday; or for the entire work shift preceding the holiday.

Part-time employees who are in pay status during the month of the holiday qualify for the holiday on a pro-rata basis. Compensation for holidays (including personal holiday) will be proportionate to the number of hours in pay status in the month to that required for full-time employment, excluding all holiday hours. Pay status includes hours worked and time on paid leave.

Sick Leave
Full-time employees earn eight hours of sick leave per month. Overtime eligible employees who are in pay status for less than 80 hours per month, earn a monthly proportionate to the number of hours in pay status, in the month to that required for full-time employment. Overtime exempt employees who are in pay status for less than 80 hours per month do not earn a monthly accrual of sick leave.

Sick leave accruals for part-time employees will be proportionate to the number of hours in pay status, in the month to that required for full-time employment. Pay status includes hours worked, time on paid leave and paid holiday.

Vacation (Annual Leave)
Full-time employees accrue vacation leave at the rates specified in (1) or the applicable collective bargaining agreement (CBA). Full-time employees who are in pay status for less than 80 nonovertime hours in a month do not earn a monthly accrual of vacation leave.

Part-time employees accrue vacation leave hours in accordance with (1) or the applicable collective bargaining agreement (CBA) on a pro rata basis. Vacation leave accrual will be proportionate to the number of hours in pay status, in the month to that required for full-time employment.

Pay status includes hours worked, time on paid leave and paid holiday.

As provided in , an employer may authorize a lump-sum accrual of vacation leave or accelerate the vacation leave accrual rate to support the recruitment and/or retention of a candidate or employee for a Washington Management Service position. Vacation leave accrual rates may only be accelerated using the rates established WAC 357-31-165.

Note: Most agencies follow the civil service rules covering leave and holidays for exempt employees even though there is no requirement for them to do so. However, agencies are required to adhere to the applicable RCWs pertaining holidays and leave.

Military Leave
Washington State supports members of the armed forces with 21 days paid military leave per year.

Bereavement Leave
Most employees whose family member or household member dies, are entitled to three (3) days of paid bereavement leave. In addition, the employer may approve other available leave types for the purpose of bereavement leave.

Additional Leave
Leave Sharing

Family and Medical Leave Act (FMLA)
Leave Without Pay

Please visit the State HR Website for more detailed information regarding benefits.

Updated 12-31-2022
01

Do you possess a minimum of seven (7) years directly relevant experience is required in leading and/or managing high visibility and high-impact programs and/or processes,ANDA minimum of three (3) years of professional experience with working with appointed and elected government executives, legislative bodies and community stakeholder groups?

02

Do you possess Knowledge of and ability to apply principles, practices and methods of systems thinking and change?

03

Do you possess knowledge of and ability to apply quantitative and qualitative research methods?

04

Do you possess knowledge of and ability to apply Lean principles, practices and methods?

05

Do you possess knowledge of and ability to apply change management principles, practices and methods?

06

Do you possess knowledge of and ability to apply advanced facilitation techniques Ability to recognize, detect, and resolve complex operational issues?

07

Do you possess the ability to create and maintain good working relationships through excellent communication and team building skills, including the ability to engage successfully with both internal and external stakeholders?

08

Do you possess exceptional communication skills, both verbal and written, including the ability to prepare and deliver clear and concise presentations, reports and data visuals/dashboards?

09

Do you possess A professional level of expertise in multiple areas of large-scale and complex operations and demonstrated use of high level discretion and judgement in execution of duties?

10

Do you possess the ability to maintain strict confidentiality and handle difficult situations with diplomacy, tact and empathy?

11

Do you possess the ability to manage and maintain simultaneous, transitional, and emerging priorities?

12

Do you possess the ability to advance DOC values, including Equity, Diversity, Inclusion and Respect?

13

3100 - Please indicate your highest level of education:

High school diploma or equivalent
Associates degree
Bachelors degree
Masters degree or higher

14

3100 - Are you a current DOC employee?

15

3100 - How did you hear about this opportunity?

Careers.wa.gov; jobs.doc.wa.gov; or governmentjobs.com
Indeed
DOC social media (Facebook, LinkedIn, Twitter)
Job/career fair
Job boards (Monster. ZipRecruiter, GlassDoor, CareerBuilder)
WorkSource
Veteran outreach
Referral from current DOC employee
Other

16

3100 - If hired for this position, do you currently possess required documents to allow you to legally work within the United States? (The below link lists acceptable documents: https://www.uscis.gov/i-9-central/form-i-9-acceptable-documents)

17

3100 - If hired for this position, will you require employer sponsorship, either now or in the future?

Required Question

Sentinel Event Program Manager (HQ)

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