Strategy Advancement Advisor - DME Operations

About this role

Become a part of our caring community   In this remote position reporting to the Director of Strategy Advancement, you will provide data-based strategic direction to identify and address business issues and opportunities. You will provide business intelligence and strategic planning support for business segments or the company at large. You will work on problems of diverse scope and complexity ranging from moderate to substantial. As Strategy Advancement Advisor, you will support the operational implementation of a pilot DME program. You will do this by partnering with the assigned project manager, internal and external partners, and downstream vendors. This partnership will ensure pilot readiness, workflow execution, issue resolution, and compliance with applicable DME requirements. You will also serve as a DME subject matter expert and provide operational guidance on DME equipment categories, fulfillment workflows, CMS guidelines, documentation requirements, and member/provider experience considerations.

As Strategy Advancement Advisor, you will lead projects to analyze complex business problems using data from internal and external sources. Bring expertise or identify subject matter experts to support multi-functional efforts to identify, interpret, and produce recommendations and plans based on company and external data analysis. Ensure that policies and procedures align with corporate vision. Selects, develops, and evaluates personnel ensuring efficient operation of the function. Advise executives to develop functional strategies (often segment specific) on matters of significance. Make independent decisions on complex issues regarding job responsibilities and related tasks. Analyze variable factors and determine the best course of action.

Responsibilities: • Serve as DME subject matter expert. Provide guidance on DME categories and related operational considerations, including respiratory, mobility, hospital beds, support surfaces, enteral, wound care, and recurring supply categories. • Lead daily operational readiness and execution activities for the DME pilot program. • Partner with operational leaders to design, validate, and implement pilot workflows. • Be the DME subject matter expert for all partners, internal and external. • Document requirements, standard operating procedures and escalation processes. • Identify and resolve operational issues related to 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.

Use your skills to make an impact   Required Qualifications • Bachelor's degree. • 8 or more years of experience working in the durable medical equipment industry, preferably for a DME supplier or DME-focused operational organization. • 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 and operational considerations across respiratory, mobility, hospital beds, support surfaces, enteral, wound care, and recurring supply categories. • Experience supporting operational implementations, pilots, vendor transitions, or new workflow rollouts. • Experience working with external vendors, providers, or supplier partners in a managed care, healthcare operations, or network management environment. • Analyze and review operational data, identify trends, and recommend corrective actions. • Must be passionate about contributing to an organization focused on improving consumer experiences.

Preferred Qualifications • Demonstrated operational leadership with the ability to drive execution without directly owning the formal project management function. • Proficiency in process mapping, workflow design, and procedure documentation. • Able to explain complex DME operational concepts to non-DME partners. • Knowledge of health plan operations, preferably Medicare Advantage

Work at Home Requirements: To ensure Home or Hybrid Home/Office employees’ ability to work effectively, the self-provided internet service of Home or Hybrid Home/Office employees must meet the following criteria: At minimum, a download speed of 25 Mbps and an upload speed of 10 Mbps is required; wireless, wired cable or DSL connection is suggested. In certain roles, the minimum recommended internet speed required by Humana may not be sufficient for business needs. Humana reserves the right to require associates to upgrade their internet service if necessary. Work from a dedicated space lacking ongoing interruptions to protect member PHI / HIPAA information.   Travel: While this is a remote position, occasional travel to Humana's offices for training or meetings may be required.  

Scheduled Weekly Hours

40 Pay Range The compensation range below reflects a good faith estimate of starting base pay for full time (40 hours per week) employment at the time of posting. The pay range may be higher or lower based on geographic location and individual pay will vary based on demonstrated job related skills, knowledge, experience, education, certifications, etc.   $115,200 - $158,400 per year   This job is eligible for a bonus incentive plan. This incentive opportunity is based upon company and/or individual performance. Description of Benefits Humana, Inc. and its affiliated subsidiaries (collectively, “Humana”) offers competitive benefits that support whole-person well-being. Associate benefits are designed to encourage personal wellness and smart healthcare decisions for you and your famil

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