Director, DTP DME Operations - Hybrid

Job Summary:

The Director of Direct‑to‑Patient (DME) Operations provides strategic leadership and end-to-end operational oversight for Wellspect’s Durable Medical Equipment (DME) service delivery model. This role owns the complete patient service lifecycle—from referral intake, eligibility and benefits verification, and clinical documentation collection through order management, fulfilment, patient onboarding, and ongoing service delivery.

This leader ensures high-quality, compliant, and patient‑centred operations that fully adhere to CMS DMEPOS Quality Standards, payer policies, accreditation requirements, and federal/state regulatory frameworks. The Director builds scalable operational infrastructure, optimizes workflows, and leverages technology to enable growth, efficiency, and service excellence.

Through strong cross-functional collaboration with clinical teams, compliance, sales, finance, revenue cycle, technology, and external manufacturer partners, the Director ensures operations are aligned to strategic business objectives while consistently delivering an exceptional experience for patients, providers, and partners.

Key Responsibilities:

Strategy & Operating Model

• Define and execute a multi-year operating strategy for Direct-to-Patient DME, aligned to growth, patient experience, cost-to-serve, and compliance objectives.
• Design scalable organizational structure, capacity models, and cross-functional workflows; establish governance and review rhythms (MBRs/QBRs).
• Build KPI dashboards and targets for intake SLAs, conversion, cycle time, clean-claim rate, denial/appeal rates, aging/backlog, fulfillment OTIF, patient NPS/CSAT, complaint rates, and cost-to-serve.

Intake, Onboarding & Referral Management

• Oversee day-to-day referral intake, eligibility checks, documentation collection, and physician/patient outreach; ensure service levels adjust to fluctuating volumes.
• Standardize and continuously improve scripts, templates, and documentation checklists to accelerate time-to-setup and reduce rework.
• Partner with manufacturer/referral partners to maintain and grow referral volume; resolve escalations promptly and professionally.

Order-to-Cash, Fulfilment & Service

• Oversee order management, picking/packing/shipping (or 3PL), delivery confirmation, and patient onboarding/training steps; ensure accurate HCPCS coding and product substitutions per policy.
• Drive proactive issue management across backorders, substitutions, RMAs/returns, and recalls; ensure warranty and service obligations are met.
• Improve first-contact resolution, response times, and quality in Customer Service; implement Voice of Customer programs and closed-loop feedback.

Compliance, Accreditation & Audit Readiness

• Ensure continuous compliance with CMS DMEPOS Quality Standards and supplier standards; always maintain survey-ready documentation.
• Lead accreditation readiness and annual surveys with CMS-approved AOs (e.g., ACHC/CHAP/HQAA) and respond to payer audits and CMS reviews.
• Own policy/procedure governance, training, and internal audit cadence across intake, product safety, documentation, and information management.

Technology, Data & Automation

• Partner with Technology to digitize workflows (e.g., e-intake, e-signature, automated eligibility/document requests), integrate systems, and enable reliable data flows for reporting.
• Deploy automation and rules engines to reduce manual touches and error rates (e.g., document validation, payer routing, status notifications).
• Leverage CRM (e.g., Salesforce) and DME platforms (e.g., Brightree or equivalent) to improve visibility, accountability, and productivity.

People Leadership

• Lead and develop managers and supervisors; hire, coach, and performance-manage teams to high standards of service, compliance, and accountability.
• Foster a culture of servant leadership, continuous improvement, and patient-centered decision making.
• Provide clear goals, training roadmaps, and career progression; recognize and reward impact.

Financial & Operating Performance

• Own operating budgets, staffing plans, and vendor contracts; manage to productivity, cost-per-order, and quality targets.
• Analyze daily/weekly KPIs and revenue attainment; implement corrective actions when performance drifts from targets.
• Prepare content for monthly business reviews and manufacturer presentations; communicate insights and action plans succinctly.

Education Requirements:

• Bachelor’s degree required (Business, Healthcare Administration, or related field).
  Master’s degree preferred.

Experience Requirements:

• 10+ years of healthcare operations experience, including 5+ years leading DME, patient services, or similar regulated service environments.
• Experience building and scaling high-volume intake, documentation, order management, or fulfillment operations.
• Proven success managing operations under strict regulatory and payer requirements.
• Familiarity with revenue cycle workflows, reimbursement, and payer audits for DME.
• Demonstrated leadership in process improvement, operational analytics, and technology-enabled transformation.

Skills and Competencies::

Operational Expertise

• Deep knowledge of DME operations, patient support workflows, reimbursement, and healthcare service delivery.
• Mastery of process design, workflow optimization, and operational analytics.

Regulatory & Compliance

• Strong understanding of CMS DMEPOS Quality Standards, accreditation requirements, payer documentation policies, and audit readiness.

Leadership & People Development

• Proven ability to build, coach, and inspire multi-functional operational teams.
• Strong change leadership, communication, and stakeholder management skills.

Technology & Data Skills

• Proficiency with CRM and DME platforms; comfort with automation and data-driven decision making.
• Ability to partner with technology teams to drive digital transformation.

Key Performance Measures:

• Referral-to-order conversion and cycle time; on-time patient setup; OTIF fulfillment.
• Clean-claim/first-pass yield; denial rate and appeal win rate; DSO improvement on DME claims.
• Accreditation/audit outcomes with zero critical findings; documentation completeness and training compliance.
• Patient/provider NPS/CSAT; complaint rate; manufacturer partner satisfaction and referral growth.
• Productivity per FTE; cost-to-serve; automation-driven reduction in manual touches.