NCQA Credentialing & Member Experience Program Lead

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

Benefits offered by this job

Medical, dental, and vision coverage

401k with company match

Tuition reimbursement

Job summary

Blue Cross and Blue Shield of North Carolina seeks a National Committee Quality Assurance (NCQA) Program Manager to lead NCQA Health Plan Accreditation activities with a focus on Credentialing and Member Experience. You will drive readiness, ensure ongoing compliance, and partner across functions to support successful survey outcomes.

The ideal candidate has strong NCQA accreditation and credentialing oversight experience, with a track record of managing cross-functional initiatives in a

Qualifications

• Bachelor’s degree or equivalent experience in health care, quality or compliance.
• 3+ years of related field experience; 5+ years if no degree.

Responsibilities

• Lead NCQA Credentialing and Recredentialing (CR) standards oversight and alignment.
• Manage annual NCQA readiness assessments and mock surveys for Credentialing and ME.
• Oversee credentialing delegates, audits, corrective actions, and reporting.
• Ensure compliance with NCQA CR standards and regulatory requirements.
• Prepare for NCQA Credentialing File Reviews and survey responses.
• Plan and oversee NCQA Health Plan Accreditation programs and timelines.
• Develop NCQA program work plan and tracking tools.
• Coordinate NCQA survey activities and stakeholder engagement.
• Serve as SME on NCQA standards for Member Experience and Credentialing/Recredentialing.

Skills

NCQA accreditation

Credentialing oversight

Project management

Cross-functional collaboration

Analytical skills

Communication skills

Microsoft Excel

PowerPoint

SharePoint

Education

Bachelor’s degree or equivalent experience

5+ years of experience in related field (in lieu of degree)

Tools

Microsoft Excel

PowerPoint

Teams

SharePoint

Job description

Blue Cross and Blue Shield of North Carolina seeks a National Committee Quality Assurance (NCQA) Program Manager to lead NCQA Health Plan Accreditation activities with a focus on Credentialing and Member Experience. You will drive readiness, ensure ongoing compliance, and partner across functions to support successful survey outcomes.

The ideal candidate has strong NCQA accreditation and credentialing oversight experience, with a track record of managing cross-functional initiatives in a