NCQA Credentialing & Quality Program Lead

Blue Cross and Blue Shield of North Carolina; Iowa (LA); On-site; USD 74,000 - 118,000; Full time

Job summary

Blue Cross NC is seeking a National Committee Quality Assurance (NCQA) Program Manager to lead our Health Plan Accreditation activities with primary focus on Member Experience and Credentialing standards. You will drive readiness, ensure ongoing compliance, and partner cross-functionally to support NCQA survey outcomes.

The role requires NCQA accreditation experience, credentialing oversight, and the ability to lead cross-functional teams toward timely, audit-ready results across programs.

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

• Lead NCQA Credentialing and Recredentialing standards compliance.
• Oversee NCQA readiness assessments and mock surveys for Credentialing and Member Experience.
• Coordinate credentialing delegates for compliance and reporting.
• Develop and maintain NCQA program work plan and tracking tools.
• Prepare NCQA file reviews and survey responses.

Skills

NCQA knowledge

Project management

Cross-functional collaboration

Analytical skills

Communication skills

Education

Bachelor's degree

Equivalent experience

Tools

Microsoft Excel

PowerPoint

Teams

SharePoint

Job description

Blue Cross NC is seeking a National Committee Quality Assurance (NCQA) Program Manager to lead our Health Plan Accreditation activities with primary focus on Member Experience and Credentialing standards. You will drive readiness, ensure ongoing compliance, and partner cross-functionally to support NCQA survey outcomes.

The role requires NCQA accreditation experience, credentialing oversight, and the ability to lead cross-functional teams toward timely, audit-ready results across programs.