NCQA Program Manager: Credentialing & Member Experience Lead

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

Benefits offered by this job

Medical, dental, and vision coverage

401k with company match

Paid time off (PTO)

Parental leave and adoption support

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 a focus on Member Experience and Credentialing standards. You will drive readiness, ensure ongoing compliance, and collaborate across departments to support NCQA survey outcomes.

The role requires NCQA accreditation experience, credentialing oversight, and the ability to coordinate with delegated entities and governance committees

Qualifications

• Bachelor’s degree or equivalent experience required or 5+ years of related work experience in lieu of degree.
• 3+ years of experience in health plan accreditation, quality, or compliance.
• Strong analytical, organizational, and problem-solving skills with attention to detail.

Responsibilities

• Lead NCQA Credentialing and Recredentialing (CR) standards and ensure compliance across policies and files.
• Conduct NCQA readiness assessments and mock surveys for Credentialing, Member Experience, and other standards.
• Oversee credentialing delegates and vendors, including performance monitoring and audits.

Education

Bachelor’s degree or equivalent experience

3+ years of experience in related field

In lieu of degree, 5+ years of experience in related field

Strong analytical, organizational, and problem‑solving skills

Excellent communication skills

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 a focus on Member Experience and Credentialing standards. You will drive readiness, ensure ongoing compliance, and collaborate across departments to support NCQA survey outcomes.

The role requires NCQA accreditation experience, credentialing oversight, and the ability to coordinate with delegated entities and governance committees