Project/Program Manager

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

1d • $73,698 - $117,917

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
• 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

Responsibilities

• 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.

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

What This Job Offers

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