Helene Jo
Senior Consultant, Compliance Solutions at ATTAC Consulting Group (ACG)- Claim this Profile
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Bio
Frank Apgar MD
Helene is an extraordinary individual who has outstanding organizational and leadership skills, is highly productive and has a strong work ethic. Her knowledge of quality improvement programs is unsurpassed. She has extensive experience in Medicare Advantage, state Medicaid and commercial Health Plan programs. In my work with her she exhibited outstanding abilities by enhancing the Plan’s existing QI Program, MA Star Activities, and managing the Credentialing and the Appeals Grievance departments all with very limited resources. I would not hesitate to hire her again should the occasion arise.
Joshua Bennett, MD MBA
I had the pleasure of working with Helene at Bravo Health until the fall of 2010. She has the organizational skills needed to respond and manage the detail regulations surrounding Medicare and Medicaid. Almost single handedly she turned around the credentialing and quality departments from a badly managed situation. Over the next two years, this resulted in a Commendable score from NCQA for the entire company.She always met deadlines and required accountability from her staff and direct reports.She would be a valuable addition to any health care organization.
Frank Apgar MD
Helene is an extraordinary individual who has outstanding organizational and leadership skills, is highly productive and has a strong work ethic. Her knowledge of quality improvement programs is unsurpassed. She has extensive experience in Medicare Advantage, state Medicaid and commercial Health Plan programs. In my work with her she exhibited outstanding abilities by enhancing the Plan’s existing QI Program, MA Star Activities, and managing the Credentialing and the Appeals Grievance departments all with very limited resources. I would not hesitate to hire her again should the occasion arise.
Joshua Bennett, MD MBA
I had the pleasure of working with Helene at Bravo Health until the fall of 2010. She has the organizational skills needed to respond and manage the detail regulations surrounding Medicare and Medicaid. Almost single handedly she turned around the credentialing and quality departments from a badly managed situation. Over the next two years, this resulted in a Commendable score from NCQA for the entire company.She always met deadlines and required accountability from her staff and direct reports.She would be a valuable addition to any health care organization.
Frank Apgar MD
Helene is an extraordinary individual who has outstanding organizational and leadership skills, is highly productive and has a strong work ethic. Her knowledge of quality improvement programs is unsurpassed. She has extensive experience in Medicare Advantage, state Medicaid and commercial Health Plan programs. In my work with her she exhibited outstanding abilities by enhancing the Plan’s existing QI Program, MA Star Activities, and managing the Credentialing and the Appeals Grievance departments all with very limited resources. I would not hesitate to hire her again should the occasion arise.
Joshua Bennett, MD MBA
I had the pleasure of working with Helene at Bravo Health until the fall of 2010. She has the organizational skills needed to respond and manage the detail regulations surrounding Medicare and Medicaid. Almost single handedly she turned around the credentialing and quality departments from a badly managed situation. Over the next two years, this resulted in a Commendable score from NCQA for the entire company.She always met deadlines and required accountability from her staff and direct reports.She would be a valuable addition to any health care organization.
Frank Apgar MD
Helene is an extraordinary individual who has outstanding organizational and leadership skills, is highly productive and has a strong work ethic. Her knowledge of quality improvement programs is unsurpassed. She has extensive experience in Medicare Advantage, state Medicaid and commercial Health Plan programs. In my work with her she exhibited outstanding abilities by enhancing the Plan’s existing QI Program, MA Star Activities, and managing the Credentialing and the Appeals Grievance departments all with very limited resources. I would not hesitate to hire her again should the occasion arise.
Joshua Bennett, MD MBA
I had the pleasure of working with Helene at Bravo Health until the fall of 2010. She has the organizational skills needed to respond and manage the detail regulations surrounding Medicare and Medicaid. Almost single handedly she turned around the credentialing and quality departments from a badly managed situation. Over the next two years, this resulted in a Commendable score from NCQA for the entire company.She always met deadlines and required accountability from her staff and direct reports.She would be a valuable addition to any health care organization.
Experience
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ATTAC Consulting Group (ACG)
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United States
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Business Consulting and Services
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1 - 100 Employee
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Senior Consultant, Compliance Solutions
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Mar 2015 - Present
Specializing in MAPD, SNP and MMP Plan program development, mock and IVA audits. Specializing in MAPD, SNP and MMP Plan program development, mock and IVA audits.
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Independent/ATTAC Consulting Group (ACG)
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Honolulu, Hawaii
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Senior Consultant
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Feb 2015 - Present
Independent contractor or consultant with expertise in health plan or government quality improvement/assurance related to healthcare outcomes, HEDIS, Medicare Advantage and Star, delegation oversight, credentialing, Medicaid, behavioral health and NCQA. Specialty is in startups, program assessments and project creation and management. Member of the ACG Clinical Management and Government Programs Groups specializing in Medicare Special Needs Plan (SNP) operations and compliance audits Independent contractor or consultant with expertise in health plan or government quality improvement/assurance related to healthcare outcomes, HEDIS, Medicare Advantage and Star, delegation oversight, credentialing, Medicaid, behavioral health and NCQA. Specialty is in startups, program assessments and project creation and management. Member of the ACG Clinical Management and Government Programs Groups specializing in Medicare Special Needs Plan (SNP) operations and compliance audits
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Blue Shield of California
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United States
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Insurance
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700 & Above Employee
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Director of Regulatory Compliance
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Mar 2014 - Jan 2015
Focused on compliance with state and federal health plan requirements in addition to NCQA accreditation.
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Director, Quality Initiatives
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Aug 2011 - Mar 2014
Responsible for the quality improvement program including accreditation, HEDIS, credentialing and all initiatives to improve the quality of care for all plan members.
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Arcadian Health Plan
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United States
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Hospitals and Health Care
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1 - 100 Employee
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VP, Quality Improvement Programs
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Sep 2010 - Aug 2011
Provides strategic and administrative oversight of Star Initiatives, Quality Improvement Program and activities, Credentialing and Appeals and Grievances for a Medicare Advantage Health Plan. Internal Subject Expert on P4P, Delegation Oversight and other related initiatives. Provides strategic and administrative oversight of Star Initiatives, Quality Improvement Program and activities, Credentialing and Appeals and Grievances for a Medicare Advantage Health Plan. Internal Subject Expert on P4P, Delegation Oversight and other related initiatives.
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Bravo Health
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United States
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Hospitals and Health Care
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100 - 200 Employee
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VP Quality
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Apr 2007 - Dec 2010
Provides administrative direction to NCQA accreditation and SNP quality activities, HEDIS and CMS Star Rating improvement, credentialing, Quality Improvement and Delegation Oversight Provides administrative direction to NCQA accreditation and SNP quality activities, HEDIS and CMS Star Rating improvement, credentialing, Quality Improvement and Delegation Oversight
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Quality Administrator
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2004 - 2007
In charge of Quality, Utilization Management, Planning, Compliance , contract oversight, and Disaster Response for the SMI population served by the Department of Health state agency, Adult Mental Health Division. Earlier served as Business Director in charge of contracts, procurement and Medicaid Rehabilitation Option (MRO). In charge of Quality, Utilization Management, Planning, Compliance , contract oversight, and Disaster Response for the SMI population served by the Department of Health state agency, Adult Mental Health Division. Earlier served as Business Director in charge of contracts, procurement and Medicaid Rehabilitation Option (MRO).
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Quality Standards Administrator
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1999 - 2004
Responsible for quality oversight of 5 Medicaid MCOs, two behavioral health carve-outs (adult and child), fraud and abuse, and QI/UM for Medicaid fee for service services for the ABD population. Contract manager for EQRO. Responsible for quality oversight of 5 Medicaid MCOs, two behavioral health carve-outs (adult and child), fraud and abuse, and QI/UM for Medicaid fee for service services for the ABD population. Contract manager for EQRO.
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Clinical Services Administrator
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1994 - 1999
Responsible for EPSDT, Quality Improvement including HEDIS, credentialing, Pharmacy, Dental, Behavioral Health, Utilization Management and Case Management for this Hawaii based Community Health Center owned Medicaid MCO. Responsible for EPSDT, Quality Improvement including HEDIS, credentialing, Pharmacy, Dental, Behavioral Health, Utilization Management and Case Management for this Hawaii based Community Health Center owned Medicaid MCO.
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Education
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1992 - 1994
University of Hawaii at Manoa
MPH, Administration and Planning -
1970 - 1972
Maryville College
BS, Elementary Education -
University at Albany, SUNY
Associates, Nursing -
University of Colorado Denver
Certificate, Pediatric Nurse Practitioner
Community
