Program Manager II, Accreditation & Regulatory Management (ARM)

CHPW • Seattle, WA

4d • Onsite

About The Position

The Program Manager II, Accreditation and Regulatory Management independently manages assigned projects, standards, and workstreams supporting Community Health Plan of Washington’s ongoing compliance with National Committee for Quality Assurance (NCQA) accreditation requirements. The role partners with business teams to translate accreditation requirements into actionable work plans, monitor readiness, conduct compliance reviews, identify and communicate risks, and support timely resolution of gaps. It serves as a subject matter expert for assigned accreditation areas and provides guidance and project oversight to help business teams meet established requirements. The position also supports accreditation surveys and continuous readiness activities, escalating significant compliance risks and organizational barriers to leadership.

The position is FLSA exempt and is not eligible for overtime. Its position grade is 66, with a 10% annual incentive target based on company, department, and individual performance goals. Salary is determined at offer based on labor market data and the candidate’s relevant experience and skills. The role works in an office environment. Candidates must successfully pass a criminal background check and must not have been sanctioned or excluded from federal or state healthcare programs. Disability-related limitations will be considered in accordance with reasonable accommodation requirements.

Requirements

• Bachelor’s degree in health care administration, public health, business administration, quality management, or a related field, or an equivalent combination of education and highly relevant experience.
• At least 3 years of experience managing projects or programs.
• Experience partnering with cross-functional business owners to interpret requirements, establish deliverables, monitor progress, and address barriers.
• Experience conducting compliance reviews, audits, readiness assessments, file reviews, or similar evaluative work.
• Experience developing work plans, tracking risks and dependencies, communicating status, and managing work through completion.
• Experience researching and applying accreditation, regulatory, contractual, or organizational requirements.
• Experience identifying process improvement opportunities and supporting implementation of improved or standardized processes.
• Ability to interpret data, identify trends, and use data insights to support reporting, monitoring, and decision-making.
• Knowledge of health plan accreditation, regulatory compliance, and quality-management principles.
• Ability to research, interpret, and apply detailed requirements to organizational operations and evidence.
• Advanced project-management, compliance-review, analytical, critical-thinking, and problem-solving skills.
• Ability to evaluate documentation and operational evidence, identify gaps, and communicate clear, actionable findings.
• Effective written and verbal communication skills, including the ability to explain complex requirements to varied audiences.
• Advanced interpersonal and facilitation skills that support collaboration and accountability across business teams.
• Demonstrated organizational, time-management, and project-management skills.
• Proficiency with Microsoft Office, including Word, PowerPoint, Outlook, Excel, and Access.
• Ability to work independently, multitask, and deal with complexity frequently.
• Successfully pass a criminal background check.
• Must not have been sanctioned or excluded from participation in federal or state healthcare programs by a federal or state law enforcement, regulatory, or licensing agency.

Nice To Haves

• Experience in a health plan, health care, quality, compliance, or accreditation environment.
• Knowledge of NCQA accreditation standards, managed care operations, and health plan regulatory requirements.

Responsibilities

• Independently manage assigned NCQA accreditation projects, standards, survey components, and recurring workstreams by developing work plans, establishing milestones, tracking dependencies and risks, and communicating progress.
• Partner with business owners to translate NCQA standards into deliverables, evidence requirements, and readiness activities; provide consultation and maintain accountability for timely completion.
• Conduct compliance reviews of files, records, reports, and other supporting documentation, along with audits and oversight activities across assigned accreditation, operational, or delegated areas.
• Assess compliance, identify issues, and support corrective action or process improvement.
• Monitor compliance gaps, corrective actions, performance, and readiness through resolution; work with business owners to address barriers and identify trends and improvement opportunities.
• Escalate overdue, insufficient, or high-risk items to ARM leadership.
• Serve as a subject matter expert for assigned accreditation standards, projects, or functional areas; research requirements, provide guidance, and escalate complex, novel, or high-risk interpretation questions.
• Lead assigned accreditation project meetings and cross-functional workgroups by establishing objectives, facilitating discussion and decisions, confirming responsibilities, and monitoring deliverables.
• Draft or support updates to policies, procedures, reports, narratives, training materials, tools, and other accreditation documentation for review and approval.
• Develop and deliver training and technical guidance on NCQA requirements, accreditation processes, evidence expectations, and readiness activities.
• Represent CHPW in assigned accreditation activities, reviews, workgroups, or external discussions within the scope of the role.
• Perform other duties as assigned.

Benefits

• Medical, prescription, dental, and vision coverage.
• Telehealth app.
• Flexible Spending Accounts and Health Savings Accounts.
• Basic Life AD&D and short- and long-term disability coverage.
• Voluntary life, critical care, and long-term care insurance.
• 401(k) retirement plan with generous employer match.
• Employee Assistance Program and Mental Fitness app.
• Financial coaching and identity theft protection.
• PTO accrual starting at 17 days per year.
• 40 hours of community service volunteer time.
• 10 standard holidays and 2 floating holidays.
• Compassion time off and jury duty pay.
• 10% annual incentive target based on company, department, and individual performance goals.

What This Job Offers

• Job Type: Full-time
• Career Level: Mid Level