Hiring: Director of Clinical Services Company: NTT DATA North America Location: Irvine, CA Job Posted Time: 2026-09-03 07:43:02 Employment Type: Hybrid Target Skills & Keywords : AI, R About the job Experience: •7 to 10 years of progressive healthcare experience, including at least 5 years in leadership within a health plan, managed care organization, accountable care organization, provider network, healthcare system, or integrated delivery model. •10 years of progressive healthcare experience, including at least 5 years in leadership within a health plan, managed care organization, accountable care organization, provider network, healthcare system, or integrated delivery model. •5 years of demonstrated success developing, implementing, and managing clinical programs such as case management, disease management, utilization management, population health, wellness, or medical management initiatives. •At least 5 years in leadership within a health plan, managed care organization, accountable care organization, provider network, healthcare system, or integrated delivery model. •Minimum 5 years of demonstrated success developing, implementing, and managing clinical programs such as case management, disease management, utilization management, population health, wellness, or medical management initiatives. Required Skills: •The Director of Clinical Services leads the Clinical Services function, overseeing case management, disease and chronic condition management, clinic services, mobile health initiatives, virtual health utilization, wellness and population health programs, and medical vendor relationships under a single accountable leader. •The Director collaborates with clinical advisors, operational leaders, data and analytics teams, underwriting, account management, and external healthcare partners to develop and execute strategies that enhance quality of care, improve member engagement, and demonstrate value to employer groups and other stakeholders. •Case Management •Design and manage a comprehensive case management program for high-cost and medically complex members, ensuring appropriate care in the most effective setting. •Oversee utilization management and pre-authorization review processes as part of the overall case management strategy. •Implement proactive outreach efforts to identify and engage high-risk members early in their healthcare journey. •Disease & Chronic Condition Management •Develop and oversee programs focused on chronic conditions such as congestive heart failure (CHF), chronic obstructive pulmonary disease (COPD), diabetes, and other high-impact health conditions. Qualifications: •Proven success building and scaling clinical operations, managing internal teams and external vendors, and driving measurable clinical and financial outcomes. •In-depth knowledge of healthcare claims data, utilization management, care coordination, risk identification, and performance measurement. •Demonstrated ability to collaborate effectively with operations, analytics, finance, underwriting, account management, and executive leadership teams. Compensation: •$170,000 - $195,000 / year Interested candidates, please apply directly through the job posting on company's career page or try via AI auto apply on this platform. Don't miss this opportunity to join a forward-thinking team!