Manager, Sentinel Event

About the role:

The Manager, Sentinel Events and Safety Reviews is responsible for leading the delivery of Safer Care Victoria's sentinel event investigation and system learning functions, with a focus on reducing preventable harm and improving patient safety across the Victorian health system.

The Manager will oversee the conduct of high-quality, no-blame root cause investigations into sentinel events and other serious safety incidents. They will lead a multidisciplinary team and draw on clinical, human factors, systems-thinking, and safety science expertise-including insights from aviation, military, and other high-reliability sectors-to identify contributory factors and enable system learning. In doing so, the Manager will ensure that findings translate into actionable recommendations that drive meaningful and lasting improvements.

Working in partnership with health services, the Manager will provide expert guidance and support throughout the incident review lifecycle, from initial investigation planning through to reporting, implementation monitoring, and sustainability assessment. They both lead and will work in partnership with other SCV Managers and Directors contributing to the development and refinement of frameworks, tools, and resources that enhance health service capability in incident investigation and risk mitigation.

Reporting to the Director, Review and System Learning, the Manager plays a key leadership role within the Safety Branch at SCV. They will actively foster a psychologically safe, collaborative, and improvement-focused team culture. The role will also work closely with peers across SCV and the Department of Health to ensure that insights from adverse events are systematically captured, shared, and embedded in practice to prevent recurrence and support a safer health system for all Victorians.

About us:

At the Victorian Department of Health we want a future where Victorians are the healthiest people in the world. A Victoria where our children and people thrive, our workplaces are productive and safe, and our communities are more connected.

We see it as our job to support Victorians to stay healthy and safe. And to deliver a world-class healthcare system that ensures every single Victorian can access safe, quality care that leads to better health outcomes for all.

About you:

• Tertiary qualification in a relevant field such as Clinical Health (e.g. Medicine, Nursing, Paramedicine, Allied Health), Public Health, Patient Safety, Health Services Management, Human Factors, Systems Engineering, or a related discipline.
• Demonstrated training or certification in incident investigation methodologies, such as root cause analysis, systems-based investigation, or human factors frameworks.
• Postgraduate qualification in one or more of the following: public health, health systems leadership, human factors, health policy, implementation science, risk management, or healthcare improvement. Additional credentials or coursework in safety science, aviation safety, high-reliability organisation principles, or system learning methodologies will be highly regarded.
• Experience with project management, change management or quality improvement methodologies (e.g. Six Sigma, Lean, PDSA cycles) is advantageous.
• Significant experience leading or conducting serious incident or sentinel event reviews within healthcare or other high-risk sectors, with proven ability to apply systems thinking, just culture principles, and multidisciplinary analysis.
• Understanding of patient safety, clinical governance, and the Victorian health system, with the ability to translate investigation findings into practical, system-level recommendations.
• Expertise in working with or integrating human factors, data analytics, and risk intelligence into safety investigations and system learning processes.
• Demonstrated ability to lead and coach high-performing teams in a sensitive and safety-critical environment, fostering psychological safety, accountability, and continuous improvement.
• Proven ability to build trust and credibility with diverse stakeholders including clinicians, executives, health service leaders, government officials, and consumers.
• Experience in developing and implementing tools, frameworks, and resources to support local capability in safety event investigation and prevention.

What we offer:

• The opportunity to perform meaningful work, making direct contributions toward enabling Victorians to be the healthiest people in the world.
• A wide range of growth and development opportunities within the department and wider Victorian Public Service & Sector.
• A strong commitment to work-life balance, including a diverse array of flexible working arrangements.

How to apply:

Applications should include a resume and a cover letter. Click the `Apply' button to view further information about the role including key contact details and the advertisement closing date.

We are committed to developing and supporting a workforce that is well equipped and highly motivated to provide responsive and quality services to all Victorians. We continue to build an inclusive workplace that embraces diversity of backgrounds and differences to realise the potential of our employees for innovation and delivering services aimed at enhancing the lives of all Victorians. All roles can be worked flexibly and we encourage applications from Aboriginal people, people with disability, LGBTIQ+ and people from culturally diverse backgrounds. Please contact us if you require any adjustments to participate in the recruitment process at For more information on our commitment to inclusion and diversity see inclusion and diversity at the Department of Health.

If you have any queries in relation to recruitment processes at Health, or experience any issues in applying, please feel free to email Please note that unsolicited applications will not be replied to. If you have questions regarding the role specifically, we would advise you to reach out to the contact listed on the advertisement directly.

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