NCQA Credentialing & Quality Program Lead

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

Benefits offered by this job

Medical insurance

Dental & vision coverage

401k match

PTO

Tuition reimbursement

Job summary

Blue Cross and Blue Shield of North Carolina is seeking a National Committee Quality Assurance (NCQA) Program Manager to lead NCQA Credentialing and Recredentialing (CR) oversight, with a focus on Member Experience and Credentialing standards. The role drives organizational readiness, ensures ongoing compliance, and partners cross-functionally to support NCQA survey outcomes.

The ideal candidate brings strong NCQA accreditation experience, with program management skills and ability to lead

Qualifications

• Bachelor’s degree or equivalent experience.
• 3+ years of experience in related field; 5+ years if no degree.
• NCQA accreditation knowledge or healthcare quality experience preferred.

Responsibilities

• Lead NCQA Credentialing and Recredentialing (CR) standards oversight.
• Conduct annual NCQA readiness assessments and mock surveys.
• Oversee credentialing delegates, audits, and corrective actions.
• Collaborate with Credentialing Operations, Network Management, and other areas to ensure compliance.
• Prepare for NCQA Credentialing File Reviews and survey responses.
• Lead planning and oversight of NCQA Health Plan Accreditation programs.

Skills

Program Management

Project Management

Budgeting

Office Administration

Process Improvements

Program Documentation

Program Evaluations

Program Implementation

Resource Allocation

Communication Skills

Education

Bachelor’s degree or equivalent experience

In lieu of degree, 5+ years of 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 NCQA Credentialing and Recredentialing (CR) oversight, with a focus on Member Experience and Credentialing standards. The role drives organizational readiness, ensures ongoing compliance, and partners cross-functionally to support NCQA survey outcomes.

The ideal candidate brings strong NCQA accreditation experience, with program management skills and ability to lead