Note: The job is a remote job and is open to candidates in USA. Humana is a healthcare company serving members through insurance and healthcare services. The Strategy Advancement Advisor will provide strategic and operational support for a durable medical equipment pilot program, serving as a DME subject matter expert and partnering with project managers, operational leaders, vendors, providers, and other stakeholders. The role will lead readiness and execution activities, resolve workflow issues, monitor performance, and recommend process improvements and future program changes.
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
Skills
- * 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
- * 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
Benefits
- This is a remote position.
- This job is eligible for a bonus incentive plan. This incentive opportunity is based upon company and/or individual performance.
- Medical, dental and vision benefits
- 401(k) retirement savings plan
- Time off (including paid time off, company and personal holidays, paid parental and caregiver leave)
- Short-term and long-term disability
- Life insurance
Company Overview
Company H1B Sponsorship