Strategy Advancement Advisor – DME Operations

This is a fully remote position, open to applicants in United States.

📋 Description

• Deliver data-driven strategic direction to identify and address business challenges and opportunities.

• Offer business intelligence and strategic planning assistance for business segments or the organization as a whole.

• Facilitate the operational implementation of a pilot durable medical equipment (DME) program.

• Collaborate with the assigned project manager, internal and external stakeholders, and downstream vendors to ensure pilot readiness, workflow execution, issue resolution, and compliance.

• Act as a DME subject matter expert, providing operational guidance on equipment categories, fulfillment workflows, CMS guidelines, documentation requirements, and the member/provider experience.

• Lead projects that analyze intricate business problems using both internal and external data.

• Identify subject matter experts and support multifunctional efforts to generate recommendations and plans.

• Ensure that policies and procedures are aligned with the corporate vision.

• Select, develop, and evaluate personnel to guarantee efficient operational functions.

• Advise executives regarding functional strategies.

• Oversee daily operational readiness and execution activities for the DME pilot.

• Design, validate, and implement pilot workflows in collaboration with operational leaders.

• Document requirements, standard operating procedures, and escalation processes.

• Identify and resolve issues related to order routing, vendor assignment, documentation, authorization, fulfillment, delivery, member experience, and provider experience.

• Monitor pilot performance metrics, identifying trends, risks, and opportunities for process improvement.

• Support post-launch stabilization, capture lessons learned, and provide recommendations for future expansion or modification.

⛳️ Requirements

• Bachelor's degree required.

• A minimum of 8 years of experience in the durable medical equipment industry.

• At least 2 years of project leadership experience.

• Experience with DME operations, including order intake, documentation review, benefit verification, prior authorization support, fulfillment, delivery, repairs, recurring supplies, and patient service.

• Knowledge of Medicare, Medicare Advantage, CMS DMEPOS coverage requirements, and DME documentation standards.

• Familiarity with DME equipment categories such as respiratory, mobility, hospital beds, support surfaces, enteral, wound care, and recurring supplies.

• Experience in supporting operational implementations, pilots, vendor transitions, or new workflow rollouts.

• Proven experience working with external vendors, providers, or supplier partners in managed care, healthcare operations, or network management.

• Ability to analyze and interpret operational data, identify trends, and recommend corrective actions.

• A passion for enhancing consumer experiences.

• Capability to drive execution without formally owning the project management function.

• Proficiency in process mapping, workflow design, and procedure documentation.

• Ability to articulate complex DME operational concepts to non-DME partners.

• Knowledge of health plan operations, particularly in Medicare Advantage.

• Minimum home internet speed of 25 Mbps download and 10 Mbps upload required.

• A dedicated workspace that ensures no ongoing interruptions to protect member PHI/HIPAA information.

🏝️ Benefits

• Bonus incentive plan based on company and/or individual performance.

• Comprehensive medical benefits.

• Dental benefits.

• Vision benefits.

• 401(k) retirement savings plan.

• Paid time off.

• Company holidays.

• Personal holidays.

• Paid parental leave.

• Paid caregiver leave.

• Short-term disability coverage.

• Long-term disability coverage.

• Life insurance.

• Support for home employees regarding self-provided internet service requirements.

• Remote work arrangement.

• Occasional travel to Humana offices for training or meetings.