Project/Program Manager

Job DescriptionWe're hiring a National Committee Quality Assurance (NCQA) Program Manager to lead our Health Plan Accreditation activities with a primary focus on Member Experience and Credentialing standards. This role drives organizational readiness, ensures ongoing compliance, and partners cross-functionally to support successful NCQA survey outcomes. The ideal candidate brings strong experience in NCQA accreditation and credentialing oversight.What You'll DoServe as the organizational lead for NCQA Credentialing and Recredentialing (CR) standards, ensuring policies, procedures, files, and oversight activities meet accreditation requirements.Lead annual NCQA readiness assessments and mock surveys for Credentialing, Member Experience, and other accreditation standards to ensure continuous survey readiness.Support oversight of credentialing delegates and vendors, including performance monitoring, annual audits, corrective action plans, and reporting to credentialing governance committees.Partner with Credentialing Operations, Network Management, other business areas and delegated entities to ensure ongoing compliance with NCQA CR standards and credentialing-related regulatory requirements.Lead preparation for and participation in NCQA Credentialing File Reviews, including file selection, audit readiness assessments, corrective actions, and survey response development.Lead planning, execution, and oversight of NCQA Health Plan Accreditation programs, ensuring alignment with organizational goals and timelinesDevelop and maintain the NCQA program work plan and tracking tools to monitor progress, risks, and compliance statusCoordinate NCQA survey activities, including documentation management, submission readiness, and stakeholder engagementServe as subject matter expert (SME) on NCQA standards, with emphasis on Member Experience and Credentialing/Recredentialing (CR)Interpret standards and partner with business owners to operationalize requirements and implement compliant processesIdentify gaps and risks; develop mitigation strategies and provide regular status reporting to leadershipConduct ongoing readiness reviews, audits, and monitoring activities to ensure sustained complianceCollaborate with business areas and cross-functional stakeholders to develop and finalize NCQA data source submission reports (e.g., Member Experience [ME 7]), ensuring accuracy, completeness, and alignment with NCQA standards and audit expectationsOversee delegated vendor functions to ensure adherence to NCQA accreditation requirementsFacilitate cross-functional workgroups, committee discussions, and Quality Improvement meetings to drive accountability and readinessEstablish and track performance metrics (process, outcome, and compliance measures) and present findings to stakeholdersDrive continuous improvement initiatives to enhance quality, efficiency, and accreditation outcomesAnalyze policies, workflows, and documentation to improve effectiveness and ensure regulatory alignmentSupport additional accreditation and compliance initiatives as neededWhat You BringBachelor's degree or equivalent experience3+ years of experience in related fieldIn lieu of degree, 5+ years of experience in related fieldBonus Points (preferred qualifications)5+ years of program or project management experience in healthcare, quality, or complianceDemonstrated experience preparing for and supporting NCQA surveys, file reviews, and accreditation submissions.Strong working knowledge of health plan credentialing operations, delegated credentialing oversight, and provider network compliance requirements.Experience leading cross-functional accreditation workgroups and driving corrective action plans through completion.Direct experience with NCQA Health Plan Accreditation standards and survey processesExperience supporting or managing Credentialing and Recredentialing (CR) activitiesProven ability to manage cross-functional initiatives and drive results in a matrixed environmentStrong understanding of accreditation compliance, evidence documentation, and audit readinessAbility to assess compliance gaps and implement actionable solutionsExcellent analytical, organizational, and problem-solving skillsStrong communication skills with the ability to influence stakeholders at all levelsProficiency in Microsoft Excel, PowerPoint, Teams, and SharePointHigh attention to detail with strong program tracking and reporting capabilitiesWhatYou'llGetThe opportunity to work at thecutting edgeof health care delivery with a teamthat'sdeeply invested in the communityWork-life balance, flexibility, and the autonomy to dogreat workMedical, dental, and vision coverage along withnumeroushealth and wellness programsParental leave and support plus adoption and surrogacyassistanceCareer development programs and tuition reimbursement for continued education401k match including an annual company contributionLearn moreSalary RangeAt Blue Cross NC, we take great pride in a fair and equitable compensation package that reflects market-price and our starting salaries are typically planned near the middle of the range listed. Compensation decisions are driven by factors including experience and training, specialized skill sets, licensure and certifications and other business and organizational needs. Our base salary is part of a robust Total Rewards package that includes an Annual Incentive Bonus*, 401(k) with employer match, Paid Time Off (PTO), and competitive health benefits and wellness programs.*Based on annual corporate goal achievement and individual performance.$73,698.00 - $117,917.00SkillsBudgeting, Office Administration, Process Improvements, Program Administration, Program Documentation, Program Evaluations, Program Implementation, Program Management, Project Management, Resource Allocation _____________________________________________________________________JOB ALERT FRAUD: We have become aware of scams from individuals, organizations, and internet sites claiming to represent Blue Cross and Blue Shield of North Carolina in recruitment activities in return for disclosing financial information. Our hiring process does not include text-based conversations or interviews and never requires payment or fees from job applicants. All our career opportunities are published on en-US/BCBSNC. If you have already provided your personal information that you suspect is fraudulent activity, please report it to your local authorities. Any fraudulent activity should be reported to: .