Director of Clinical Services

At NTT DATA, we know that with the right people on board, anything is possible. The quality, integrity, and commitment of our employees have been key factors in our company’s growth and market presence. By hiring the best people and helping them grow both professionally and personally, we ensure a bright future for NTT DATA and for the people who work here.

For more than 25 years,NTT DATA have focused on impacting the core of your business operations with industry-leading outsourcing services and automation. With our industry-specific platforms, we deliver continuous value addition, and innovation that will improve your business outcomes. Outsourcing is not just a method of gaining a one-time cost advantage, but an effective strategy for gaining and maintaining competitive advantages when executed as part of an overall sourcing strategy.

NTT DATA currently seeks a Director of Clinical Services to join our team in Irvine, CA.

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.

This role is responsible for proactively managing healthcare costs while improving member health outcomes and experience. The Director serves as the strategic and clinical leader of an integrated care model that connects case management, utilization management, clinical programs, provider networks, and health data to identify high-risk populations, improve care coordination, and drive measurable outcomes.

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.

• 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.

• 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.
• Coordinate care for members with complex or high-cost health needs to reduce avoidable hospital admissions and readmissions.
• Support medication adherence and advocacy initiatives that improve health outcomes.

• Drive utilization of clinic-based, mobile health, and virtual care services by connecting members to the most appropriate care setting.
• Develop reporting and visibility into utilization trends, outcomes, member engagement, and program value.

• Lead wellness, prevention, and population health initiatives, including biometric screening programs and chronic disease outreach.
• Design and implement member education campaigns focused on preventive care and healthy lifestyle behaviors.
• Increase engagement among underserved or disengaged populations and improve access to primary care services.

• Serve as the clinical owner of healthcare vendor relationships, including care delivery organizations, virtual health providers, specialty clinical programs, and other medical service partners.
• Establish clinical performance expectations, oversee quality and member experience outcomes, and ensure accountability across vendor partnerships.
• Provide clinical guidance related to provider networks, healthcare access, site-of-care decisions, pharmacy benefits, specialty medications, and utilization management strategies.
• Evaluate prospective vendors and clinical programs based on quality, outcomes, and value, while leading build-versus-buy assessments.
• Develop and facilitate ongoing performance reviews using clinical quality measures, operational metrics, and cost outcomes.

• Provide clinical guidance and support for healthcare service expansion initiatives, including clinic and mobile health operations.
• Partner with…