NCQA Credentialing & Member Experience Lead

Blue Cross and Blue Shield of North Carolina; Maryland; On-site; USD 74,000 - 118,000; Full time

Benefits offered by this job

Medical, dental, and vision coverage

Parental leave and adoption assistance

Tuition reimbursement and continued‑ed

Job summary

Blue Cross and Blue Shield of North Carolina is seeking a National Committee Quality Assurance (NCQA) Program Manager to lead Health Plan Accreditation activities with emphasis on Member Experience and Credentialing standards. This role drives readiness, ensures ongoing compliance, and collaborates across functions to support NCQA survey outcomes.

The ideal candidate has extensive NCQA accreditation experience, credentialing oversight expertise, and a proven ability to manage cross‑functional

Qualifications

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

Responsibilities

• Serve as organizational lead for NCQA Credentialing and Recredentialing standards.
• Lead NCQA readiness assessments and mock surveys for Credentialing and Member Experience.
• Oversee credentialing delegates and vendors, including performance monitoring and audits.
• Coordinate NCQA survey activities, documentation management, and stakeholder engagement.
• Develop and maintain the NCQA program work plan and tracking tools.
• Lead preparation for NCQA Credentialing File Reviews and survey responses.
• Establish metrics and report findings to leadership.

Skills

Strong communication skills

Analytical abilities

Project management experience

Stakeholder influence

Education

Bachelor’s degree or equivalent experience

Tools

Microsoft Excel

PowerPoint

Teams

SharePoint

Job description

Blue Cross and Blue Shield of North Carolina is seeking a National Committee Quality Assurance (NCQA) Program Manager to lead Health Plan Accreditation activities with emphasis on Member Experience and Credentialing standards. This role drives readiness, ensures ongoing compliance, and collaborates across functions to support NCQA survey outcomes.

The ideal candidate has extensive NCQA accreditation experience, credentialing oversight expertise, and a proven ability to manage cross‑functional