Helena Moon Email and Phone Number

Responsible for managing contracts for federal and state run healthcare programs intended to improve quality of care for Medicare and/or Medicaid beneficiaries, families, and caregivers in 5 states (over 7.6M Medicare beneficiaries)Manage and oversee the processing/analysis of various data sources such as Medicare claims data, National Healthcare Safety Network (NHSN) data; develop and disseminate medically meaningful and commercially useful presentations and reports for medical directors and executive healthcare administrators; provided technical assistance on the use of data and the interpretation of findings to guide the development of interventions to improve quality of care and to meet business goal; achieve the project goals of reducing health care associated infections, adverse drug events, and improving prevention and early diagnosisProvide division-wide trainings; understand/stay current with major federal healthcare policies and regulations; serve as clinical/scientific/research resource within the division

Project Manager for CMS’ Partnership for Patients (PfP), Financial Alignment Demonstration (FAD), and California Department of Public Health Skilled Nursing Facility Quality and Accountability Program (CDPH SNF QAP). Responsible for managing all aspects of the project, including budget, recruitment strategies, project timelines, collaborative team meetings with the clients, and attending/providing educational and training presentations. Engaged with key state and federal representatives to provide strategic guidance based on programmatic, analytic and clinical/scientific expertise. Collaborated with commercial, compliance, regulatory, clinical, and quality assurance entities. Extensive experience in performing literature review, research, and professional reports.PfP is a national initiative aimed at reducing patient harm and readmissions by 40 percent and 20 percent, respectively. Activities involved the evaluation of the progress made with regard to established patient safety goals and program impact on health care nationwide. FAD, administered by the MMCO and the CMMI, is an effort to coordinate care for enrollees who are eligible for both Medicare and Medicaid, to decrease financial misalignment and to integrate primary, acute, behavioral health and long-term services and supports for the enrollees by partnering with States and health plans. Activities involved managing the monitoring activities to ensure the delivery of consistent, high quality care, and access for new enrollees throughout the demonstration period, as well as readiness review to ensure that health plans are adequately equipped to provide necessary services to the members. SNF QAP is a pay-for-performance initiative aimed at measuring and improving the quality of nursing home care in California. Activities include analysis of CDPH staffing data and CMS MDS measures, environmental scans of existing and potential measures for consideration in the SNF QAP, and development of new measures.