Strategy Advancement Advisor – DME Operations

🔥 0 minutes ago

🇺🇸 United States – Remote

💵 $115.2k - $158.4k / year

⏰ Full Time

🟠 Senior

🔴 Lead

⚙️ Operations

🦅 H1B Visa Sponsor

This company has sponsored H1B visas in the past.

Apply Now

Find Similar Remote Jobs

Set Up Email Alert For New Jobs

📊 Check your resume score for this job

Improve your chances of getting an interview by checking your resume score before you apply.

Upload Resume

Humana

WebsiteLinkedInAll Job Openings

10,000+ employees

Founded 1961

🏥 Healthcare

🛡️ Insurance

⚕️ Healthcare Insurance

Healthcare • Insurance • Healthcare Insurance

Humana is a healthcare company dedicated to making a positive impact on the health of individuals, communities, and the healthcare system as a whole. With a focus on putting health first, Humana serves a diverse range of populations, including seniors and the military, providing Medicare Advantage HMO, PPO, and PFFS plans. Humana is committed to fostering a culture of belonging and mutual respect, offering competitive and flexible benefits to ensure the financial security of its employees and their families. The company prides itself on creating an inclusive workplace where everyone has the opportunity to succeed.

📋 Description

• Provide data-based strategic direction to identify and address business issues and opportunities • Provide business intelligence and strategic planning support for business segments or the company • Support operational implementation of a pilot durable medical equipment (DME) program • Partner with the assigned project manager, internal and external partners, and downstream vendors to ensure pilot readiness, workflow execution, issue resolution, and compliance • Serve as a DME subject matter expert and provide operational guidance on equipment categories, fulfillment workflows, CMS guidelines, documentation requirements, and member/provider experience • Lead projects analyzing complex business problems using internal and external data • Identify subject matter experts and support multifunctional efforts to produce recommendations and plans • Ensure policies and procedures align with corporate vision • Select, develop, and evaluate personnel to ensure efficient function operations • Advise executives on functional strategies • Lead daily operational readiness and execution activities for the DME pilot • Design, validate, and implement pilot workflows with operational leaders • Document requirements, standard operating procedures, and escalation processes • Identify and resolve issues involving order routing, vendor assignment, documentation, authorization, fulfillment, delivery, member experience, and provider experience • Monitor pilot performance metrics and identify trends, risks, and process improvement opportunities • Support post-launch stabilization, lessons learned, and recommendations for future expansion or modification

🎯 Requirements

• Bachelor's degree • 8 or more years of experience working in the durable medical equipment industry • 2 or more 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 including respiratory, mobility, hospital beds, support surfaces, enteral, wound care, and recurring supplies • Experience supporting operational implementations, pilots, vendor transitions, or new workflow rollouts • Experience working with external vendors, providers, or supplier partners in managed care, healthcare operations, or network management • Ability to analyze and review operational data, identify trends, and recommend corrective actions • Passion for improving consumer experiences • Ability to drive execution without directly owning the formal project management function • Proficiency in process mapping, workflow design, and procedure documentation • Ability to explain complex DME operational concepts to non-DME partners • Knowledge of health plan operations, preferably Medicare Advantage • Minimum home internet speed of 25 Mbps download and 10 Mbps upload • Dedicated workspace without ongoing interruptions to protect member PHI/HIPAA information

🏖️ Benefits

• Bonus incentive plan based upon company and/or individual performance • 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 • Long-term disability • Life insurance • Self-provided internet service requirements/support for home employees • Remote work arrangement • Occasional travel to Humana offices for training or meetings