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 Services 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 Services currently seeks a **Team Lead- CCA** to join our team in **remote in the USA.** **Role Responsibilities** + Design, implement, and maintain care models aligned with State of Oregon requirements and health plan policies. + Support all CM/UM processes including assessments, care planning, member education, documentation, and longitudinal tracking. + Ensure care plans generate correctly within CCA and require fewer manual adjustments. + Develop and maintain clinical criteria within the CCA platform. + Integrate with external clinical criteria vendors (e.g., InterQual, MCG) to support consolidated clinical reviews. + Embed medical policy guidelines to enable: + Autoauthorization where appropriate + Automated escalation to clinical reviewers only when necessary + Implement automated counters and restriction logic to eliminate manual tracking of authorization limits. + Update and optimize care workflows, introducing automation to reduce human intervention. + Build: + Triggerbased notifications + Counterbased workflow advancements + Functional care plan automation + Create and maintain advanced operational reporting, dashboards, and performance metrics for UM and CM. + Compensate for the absence of an internal analytics module by developing external, automated data extraction and visualization processes. + Implement predictive modeling to identify: + Gaps in care + Highrisk members + Caseload balancing needs + Support integrations with: + EMRs + Provider portals + Any required interoperability endpoints + Maintain integration architecture that allows seamless information flow, realtime data sharing, and automated updates into CCA workflows. + Excessive manual processing in UM and CM **Required Skills/Experience** + 5+ years of UM and CM configuration within CCA or comparable platforms + 2+ years designing automated, rulesbased authorization processes + 2+ years building analytic models, dashboards, and operational reporting + 2+ years managing complex healthcare integrations + High School Diploma or GED **Preferences** + Experience Implementing clinical criteria and medical policy logic + Supporting compliance requirements across Medicare, Medicaid, and CMS regulations + Associates or Bachelor's degree \#LI-NorthAmerica About NTT DATA Services: NTT DATA Services is a recognized leader in IT and business services, including cloud, data and applications, headquartered in Texas. As part of NTT DATA, a $30 billion trusted global innovator with a combined global reach of over 80 countries, we help clients transform through business and technology consulting, industry and digital solutions, applications development and management, managed edge-to-cloud infrastructure services, BPO, systems integration and global data centers. We are committed to our clients' long-term success. Visit nttdata.com or LinkedIn to learn more. NTT DATA Services is an equal opportunity employer and considers all applicants without regarding to race, color, religion, citizenship, national origin, ancestry, age, sex, sexual orientation, gender identity, genetic information, physical or mental disability, veteran or marital status, or any other characteristic protected by law. We are committed to creating a diverse and inclusive environment for all employees. If you need assistance or an accommodation due to a disability, please inform your recruiter so that we may connect you with the appropriate team. Where required by law, NTT DATA provides a reasonable range of compensation for specific roles. The starting hourly range for this remote role is **($40 - $60/hourly)** . This range reflects the minimum and maximum target compensation for the position across all US locations. Actual compensation will depend on several factors, including the candidate's actual work location, relevant experience, technical skills, and other qualifications. This position is eligible for company benefits that will depend on the nature of the role offered. Company benefits may include medical, dental, and vision insurance, flexible spending or health savings account, life, and AD&D insurance, short-and long-term disability coverage, paid time off, employee assistance, participation in a 401k program with company match, and additional voluntary or legally required benefits.