Job Description
We’re hiring a National Committee Quality Assurance (NCQA) Program Manager to lead our Health Plan Accreditation activities with a primary focus on Member Experience and Credentialing standards. This role drives organizational readiness, ensures ongoing compliance, and partners cross-functionally to support successful NCQA survey outcomes. The ideal candidate brings strong experience in NCQA accreditation and credentialing oversight.What You’ll Do
- Serve as the organizational lead for NCQA Credentialing and Recredentialing (CR) standards, ensuring policies, procedures, files, and oversight activities meet accreditation requirements.
- Lead annual NCQA readiness assessments and mock surveys for Credentialing, Member Experience, and other accreditation standards to ensure continuous survey readiness.
- Support oversight of credentialing delegates and vendors, including performance monitoring, annual audits, corrective action plans, and reporting to credentialing governance committees.
- Partner with Credentialing Operations, Network Management, other business areas and delegated entities to ensure ongoing compliance with NCQA CR standards and credentialing-related regulatory requirements.
- Lead preparation for and participation in NCQA Credentialing File Reviews, including file selection, audit readiness assessments, corrective actions, and survey response development.
What You Bring
- Bachelor's degree or equivalent experience
- 3+ years of experience in related field
- In lieu of degree, 5+ years of experience in related field
Bonus Points (preferred qualifications)
- 5+ years of program or project management experience in healthcare, quality, or compliance
- Demonstrated experience preparing for and supporting NCQA surveys, file reviews, and accreditation submissions.
- Strong working knowledge of health plan credentialing operations, delegated credentialing oversight, and provider network compliance requirements.
- Experience leading cross-functional accreditation workgroups and driving corrective action plans through completion.
- Direct experience with NCQA Health Plan Accreditation standards and survey processes
- Experience supporting or managing Credentialing and Recredentialing (CR) activities
- Proven ability to manage cross-functional initiatives and drive results in a matrixed environment
- Strong understanding of accreditation compliance, evidence documentation, and audit readiness
- Ability to assess compliance gaps and implement actionable solutions
- Excellent analytical, organizational, and problem-solving skills
- Strong communication skills with the ability to influence stakeholders at all levels
- Proficiency in Microsoft Excel, PowerPoint, Teams, and SharePoint
- High attention to detail with strong program tracking and reporting capabilities
What You’ll Get
- The opportunity to work at the cutting edge of health care delivery with a team that’s deeply invested in the community Work-life balance, flexibility, and the autonomy to do great work
- Medical, dental, and vision coverage along with numerous health and wellness programs
- Parental leave and support plus adoption and surrogacy assistance
- Career development programs and tuition reimbursement for continued education
- 401k match including an annual company contribution
- Learn more
Salary Range
At Blue Cross NC, we take great pride in a fair and equitable compensation package that reflects market-price and our starting salaries are typically planned near the middle of the range listed. Compensation decisions are driven by factors includi
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