Rural Health Transformation (RHT) Program Director (WMS3/SPI) - Project
State of Washington
FreshPosted Feb 18
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Posted: February 19, 2026 (2 days ago)
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Rural Health Transformation Senior Financial Manager (WMS/FS) - Project
State of Washington
Health Care Authority
Location
Washington, 98504
Salary
$87,660 - $122,724
per year
Type
Full-Time
More Finance & Accounting jobs →Closes
March 3, 2026
Job Description
Summary
This job involves leading the financial side of a major federal program to improve rural healthcare in Washington State, including managing budgets, grants, and a small team of analysts until 2030.
It focuses on using up to $1 billion in funding to build better health systems, recruit workers, and support rural providers.
A good fit would be someone with strong financial management experience in government or healthcare, who enjoys strategic planning and working with diverse teams.
Key Requirements
- Experience in financial management, budgeting, and fiscal analysis, especially in healthcare or government settings
- Ability to manage and oversee annual budgets, including chart of accounts, allotments, and decision packages
- Supervisory skills to directly manage two fiscal analysts, including planning, assigning work, and providing direction
- Strong collaboration and communication skills to work with internal teams, external agencies, policy staff, and stakeholders
- Knowledge of federal grants and compliance, particularly with CMS and rural health initiatives
- Proficiency in providing fiscal consultation, conflict resolution, and analysis on complex projects
- Commitment to applying an equity lens in all financial analyses and processes
Full Job Description
Rural Health Transformation Senior Financial Manager (WMS/FS) - Project
71113060
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.
About the division:
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.
About the position: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 onsite work will vary based on business and operational needs. HCA has currently suspended the ability to support out-of-state telework.
Requirements
Some of what you will do:
- 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.
Qualifications
Required qualifications:
Qualifying candidates will meet one of the following criteria options:
Option 1:
- Bachelor’s degree in business administration, accounting, or other fiscally oriented field.
- Four (4) years of professional experience working with large, complex financial systems/information, including one (1) year of experience supervising staff and managing their work activities and reviewing work deliverables.
Option 2:
- Eight (8) years of professional experience working with large, complex financial systems/information, including one (1) year of experience supervising staff and managing their work activities and reviewing work deliverables.
Required competencies:
- The ability to take action to learn and grow.
- The ability to take action to meet the needs of others.
- Understanding of public policy and budget development.
- Skilled in high-level political acumen.
- Skilled in personal resourcefulness.
- The ability to work with elected officials, agency executives, senior managers and hired consultants.
Leadership and Influencing Skills
- The ability to manage the activities of subordinates, including assigning duties and tasks, monitoring work activities, removing operational and political barriers that prevent or slow subordinate activities, and reviewing and approving deliverables.
- The ability to form and maintain respectful professional relationships with HCA, RHT initiatives program, and other external staff, to influence and motivate, even if there is no official authority over them.
Financial Technical Skills
- Expert understanding of federal, state, and agency policies, principles, procedures, regulations, and computer operating systems that govern and manage financing, grant management, accounting, budgeting, financial and management reporting, data analytics, and communications.
- A thorough understanding of the federal Medicaid program, the state’s Apple Health healthcare assistance program, state financial policies and processes.
- The ability to lead the creation and documentation of fiscal work processes and monitor processes to ensure compliance.
- The ability to lead the financial analysis of data, identification of data needs, development of problem-solving strategies, development of goals and priorities, and establishment of metrics and benchmarks.
- The ability to lead the analysis and research necessary to explain differences among budgeted and forecasted expenditures and actual expenditures and effectively communicate the reason for the differences.
- Broad and deep understanding of standard financial management functions, how Washington State applies those functions to state fiscal processes, and how the state customizes those processes for the Medicaid program.
Communication Skills
- Effective oral and written communication skills, including the ability to translate complex financial/analytical information for non-financial/analytical audiences.
- Experience communicating with a broad array of audiences, ranging from those with little financial background, highly skilled financial experts, and elected government officials and auditors.
Preferred/Desired Education, Experience, and Competencies:
- Master’s Degree in relevant area.
- Fiscal and executive experience in healthcare purchasing is strongly preferred.
Financial Technical Skills
- Professional experience with applying generally accepted accounting principles to a government healthcare purchasing environment.
- The ability to tailor work to accommodate accrual (state system) and cash (federal system) accounting and efficiently frame and reconcile financial information across different fiscal year definitions.
- Working experience with the development of state operating budgets, including experience writing decision packages (budget requests).
- Expert/advanced level skills with Microsoft Excel and working knowledge of pivot tables and nested formulas.
- The ability to lead the creation and maintenance of electronic tools to aid in the financial management of the RHT initiatives.
Healthcare Experience and Skills
- Direct experience overseeing the financial management of a healthcare purchasing organization.
- Direct experience in a healthcare provider or agency that focuses on rural communities.
Government Experience
- Direct experience using the Washington State Agency Financial Reporting System (AFRS) financial data to inform reports and analyses.
- Direct experience composing, reviewing and approving decision packages and fiscal notes.
- Direct experience as a participant in the protocols/processes of the executive/legislative branches of state government.
- Direct experience communicating with federal government staff, other regulators, and external auditors.
How to apply:
Only candidates who reflect the minimum qualifications on their NEOGOV profile will be considered. Failure to follow the application instructions below may lead to disqualification.
To apply for this position, you will need to complete your profile which includes three professional references and attach in separate files:
- A cover letter that specifically addresses how you meet the qualifications for this position
- Current resume
To take advantage of veteran preference, please do the following:
- Attach a copy of your DD214 (Member 4 long-form copy), NGB 22, or USDVA signed verification of service letter.
- Please black out any PII (personally identifiable information) data such as social security numbers. Include your name as it appears on your application in careers.wa.gov.
Additional Information
About HCA:
Functioning as both the state's largest health care purchaser and its behavioral health authority, the Washington State Health Care Authority (HCA) is a leader in ensuring Washington residents have the opportunity to be as healthy as possible.
There are three pillars of our work: Apple Health (Medicaid); the Public Employees Benefits Board (PEBB) and School Employees Benefits Board (SEBB) programs; and behavioral health and recovery.
Under these pillars, HCA purchases health care, including behavioral health treatment for more than 2.7 million Washington residents and provides behavioral health prevention, crisis, and recovery supports to all Washington residents.
What we have to offer:
- Meaningful work with friendly co-workers who care about those we serve Voices of HCA
- A clear agency mission that drives our work and is person-centered HCA's Mission, Vision & Values
- A healthy work/life balance, including alternative/flexible schedules and mobile work options.
- A great total compensation and benefit package WA State Government Benefits
- A safe, pleasant workplace in a convenient location with restaurants, and shopping nearby.
- And free parking!
Notes:
Prior to a new hire, a background check including criminal record history will be conducted. Information from the background check will not necessarily preclude employment.
HCA is an equal opportunity employer. We value the importance of creating an environment in which all employees can feel respected, included, and empowered to bring unique ideas to the agency.
HCA has five employee resource groups (ERGs). ERGs are voluntary, employee-led groups whose aim is to foster a diverse, inclusive workplace aligned with HCA’s mission.
Our diversity and inclusion efforts include embracing different cultures, backgrounds and viewpoints while fostering growth and advancement in the workplace.
Studies have shown women, racial and ethnic minorities, and persons of disability are less likely to apply for jobs unless they feel they meet every qualification as described in a job description.
Persons over 40 years of age, disabled and Vietnam era veterans, as well as people of all sexual orientations and gender identities are also encouraged to apply.
If you have any questions about the required qualifications or how your experience relates to them, please contact us at HCAjobs@hca.wa.gov.
Persons with disabilities needing assistance in the application process, or those needing this job announcement in an alternative format may contact Angelic Matthews at angelic.matthews@hca.wa.gov
The Washington State Health Care Authority (HCA) is an E-Verify employer. All applicants with a legal right to work in the United States are encouraged to apply.
E-Verify® is a registered trademark of the U.S. Department of Homeland Security.
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