Project/Program Manager

Blue Cross and Blue Shield of North Carolina • Remote Flex - North Carolina, NC

2d • $73,698 - $117,917 • Hybrid

About The Position

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.

Requirements

• Bachelor's degree or equivalent experience
• 3+ years of experience in related field
• In lieu of degree, 5+ years of experience in related field

Nice To Haves

• 5+ years of program or project management experience in healthcare, quality, or compliance
• 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

Responsibilities

• Lead planning, execution, and oversight of NCQA Health Plan Accreditation programs, ensuring alignment with organizational goals and timelines
• Develop and maintain the NCQA program work plan and tracking tools to monitor progress, risks, and compliance status
• Coordinate NCQA survey activities, including documentation management, submission readiness, and stakeholder engagement
• Serve as subject matter expert (SME) on NCQA standards, with emphasis on Member Experience and Credentialing/Recredentialing (CR)
• Interpret standards and partner with business owners to operationalize requirements and implement compliant processes
• Identify gaps and risks; develop mitigation strategies and provide regular status reporting to leadership
• Conduct ongoing readiness reviews, audits, and monitoring activities to ensure sustained compliance
• Collaborate with business areas and cross-functional stakeholders to develop and finalize NCQA data source submission reports (e.g., Member Experience [ME 7]), ensuring accuracy, completeness, and alignment with NCQA standards and audit expectations
• Oversee delegated vendor functions to ensure adherence to NCQA accreditation requirements
• Facilitate cross-functional workgroups, committee discussions, and Quality Improvement meetings to drive accountability and readiness
• Establish and track performance metrics (process, outcome, and compliance measures) and present findings to stakeholders
• Drive continuous improvement initiatives to enhance quality, efficiency, and accreditation outcomes
• Analyze policies, workflows, and documentation to improve effectiveness and ensure regulatory alignment
• Support additional accreditation and compliance initiatives as needed

Benefits

• 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
• Annual Incentive Bonus
• Paid Time Off (PTO)

What This Job Offers

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