Project Manager / Program Manager

🕒 August 5

🌲 North Carolina – Remote

🌲 North Carolina – Remote

💵 $73.7k - $117.9k / year

⏰ Full Time

🟡 Mid-level

🟠 Senior

👷‍♀️ Project Manager

👻 Ghost score 10%

What it means: how likely this posting is sitting open without active hiring.How to read it: 60% or higher means we think this is a ghost. Lower scores are less of a worry.How we score it: age, reposts, open roles vs team size, how fast jobs close, and whether pay is listed.Fine print: an estimate from public data, not a judgment of the company. Real jobs can score high, so treat it as a hint, not a fact.

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Blue Cross NC

WebsiteLinkedInAll Job Openings

5001 - 10000 employees

Founded 1933

🏥 Healthcare

🛡️ Insurance

⚕️ Healthcare Insurance

Healthcare • Insurance • Healthcare Insurance

Blue Cross NC is a health insurance provider that offers a range of health plans and services to individuals and groups. The company focuses on delivering quality healthcare coverage and improving health outcomes for its members through innovative health programs and services. Blue Cross NC is committed to enhancing access to affordable healthcare while supporting the health and wellness of the communities it serves.

📋 Description

• Serve as the organizational lead for NCQA Credentialing and Recredentialing (CR) standards. • Ensure 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. • Support oversight of credentialing delegates and vendors through 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. • Drive organizational readiness, ongoing compliance, and successful NCQA survey outcomes.

🎯 Requirements

• Bachelor's degree or equivalent experience • 3+ years of experience in related field • In lieu of degree, 5+ years of experience in related field • 5+ years of program or project management experience in healthcare, quality, or compliance preferred • Demonstrated experience preparing for and supporting NCQA surveys, file reviews, and accreditation submissions preferred • Strong working knowledge of health plan credentialing operations, delegated credentialing oversight, and provider network compliance requirements preferred • Experience leading cross-functional accreditation workgroups and driving corrective action plans through completion preferred • Direct experience with NCQA Health Plan Accreditation standards and survey processes preferred • Experience supporting or managing Credentialing and Recredentialing (CR) activities preferred • Proven ability to manage cross-functional initiatives and drive results in a matrixed environment preferred • Strong understanding of accreditation compliance, evidence documentation, and audit readiness preferred • Ability to assess compliance gaps and implement actionable solutions preferred • Excellent analytical, organizational, and problem-solving skills preferred • Strong communication skills with the ability to influence stakeholders at all levels preferred • Proficiency in Microsoft Excel, PowerPoint, Teams, and SharePoint preferred • High attention to detail with strong program tracking and reporting capabilities preferred

🏖️ Benefits

• Work-life balance, flexibility, and autonomy • Medical, dental, and vision coverage • Health and wellness programs • Parental leave and support • Adoption and surrogacy assistance • Career development programs • Tuition reimbursement for continued education • 401k match including an annual company contribution • Paid Time Off (PTO) • Annual Incentive Bonus based on annual corporate goal achievement and individual performance