Quality Program Lead - Credentialing Oversight & Compliance

Johns Hopkins Medicine; Hanover (MD); On-site; USD 52,000 - 86,000; Full time

Job summary

Johns Hopkins Medicine seeks a Quality Program Manager to oversee delegated credentialing oversight, ensuring compliance with NCQA, CMS, DHA and related standards. The role leads evaluation of delegates, monitors performance, and drives corrective actions to maintain quality and regulatory readiness.

The position partners with Credentialing leadership and cross-functional teams to develop data and reporting, align processes, and strengthen credentialing practices across applicable standards.

Qualifications

• Bachelor's degree in Health Administration, Project Management or related field.
• 7+ years of experience managing programs and projects, including leadership, lifecycle methodologies, and budgets.
• Experience coordinating delegated credentialing activities and ensuring regulatory compliance.

Responsibilities

• Oversee delegation and monitoring of credentialing functions to meet NCQA, CMS, DHA, Qlarant/MDH, ERISA and other standards.
• Prepare reporting and documentation for leadership and external reviews of delegated credentialing operations.
• Collaborate with Credentialing leadership, operations, analytics and cross-functional teams to improve data, systems, and processes.
• Support pre-delegation assessments and monitor delegated entity performance, findings, and corrective actions.

Education

Bachelor's Degree in Health Administration, Project Management or related degree

Job description

Johns Hopkins Medicine seeks a Quality Program Manager to oversee delegated credentialing oversight, ensuring compliance with NCQA, CMS, DHA and related standards. The role leads evaluation of delegates, monitors performance, and drives corrective actions to maintain quality and regulatory readiness.

The position partners with Credentialing leadership and cross-functional teams to develop data and reporting, align processes, and strengthen credentialing practices across applicable standards.