Quality & Accreditation Lead — HEDIS & NCQA Expert

Blue Cross Blue Shield Association; Washington (District of Columbia); On-site; USD 149,000 - 202,000; Full time

Benefits offered by this job

Annual bonus incentive pay

Health insurance

401(k) matching

Paid time off

11 holidays

Job summary

Blue Cross Blue Shield Association seeks a senior leader to direct the Quality and Accreditation Operations department, guiding strategy for improving the quality of care, customer service and resource use across FEP membership and Plan needs. You will translate accreditor standards into actionable tasks and drive improvements in member outcomes through data-driven programs.

The role requires deep expertise in HEDIS, NCQA and URAC, proven cross-functional leadership, and the ability to manage

Qualifications

• Bachelor's degree in related discipline or RN, equivalent experience.
• 7+ years in health care with progressive project management responsibility.
• Strong knowledge of accreditor standards (HEDIS/NCQA/URAC).
• Excellent communication and presentation skills.

Responsibilities

• Lead accreditation operations and ensure compliance with standards.
• Develop and monitor annual budget and project plans.
• Coordinate cross-functional initiatives withPlans and vendors.
• Create and present strategic content for conferences and calls.

Skills

HEDIS knowledge

NCQA/URAC accreditation

Quality improvement

Project management

Leadership

PowerPoint

Public speaking

Stakeholder management

Education

Bachelor's degree in related discipline

Registered Nurse or clinical discipline

Tools

Microsoft Office

PowerPoint

Job description

Blue Cross Blue Shield Association seeks a senior leader to direct the Quality and Accreditation Operations department, guiding strategy for improving the quality of care, customer service and resource use across FEP membership and Plan needs. You will translate accreditor standards into actionable tasks and drive improvements in member outcomes through data-driven programs.

The role requires deep expertise in HEDIS, NCQA and URAC, proven cross-functional leadership, and the ability to manage