[Hiring] Quality Review and Audit Lead Analyst @The Cigna Group

Role Description

The Lead Analyst is responsible for facilitating analysis, research, and risk assessment of claims and system processing issues. This role leverages deep technical expertise in quality principles to perform thorough root cause and corrective action analysis, driving continuous improvement and supporting strategic enterprise initiatives. The Lead Analyst partners with cross-functional teams to resolve complex issues, design and implement corrective action plans, and champion operational excellence across the organization.

• Facilitate root cause investigations and develop actionable recommendations for systemic improvements.
• Review, analyze, and appropriately disposition tickets for root cause/corrective action analysis.
• Collaborate with business partners to establish correct root causes and implement solid corrective/preventive actions.
• Utilize system platforms (e.g., Service Now, RSAM, Polaris) to manage tickets and capture trend information.
• Support projects and initiatives that drive department and enterprise strategy.
• Partner with Service Operations and Customer Services to execute action plan deliverables.
• Share and communicate pertinent information with internal partners.
• Design and implement corrective action plans in collaboration with enterprise stakeholders.
• Build strong relationships across teams to achieve shared goals.

Qualifications

• 3–5 years’ experience in root cause and corrective/preventive action analysis.
• Bachelor’s degree preferred, advanced degree or equivalent experience a plus.
• Extensive knowledge of claims adjudication processes and issue management methodologies.
• Strong proficiency in Microsoft Office (Outlook, Word, Excel, PowerPoint, SharePoint).
• Knowledge of ESI platforms preferred (Service Now, RSAM, Polaris).
• Demonstrated experience in financial reconciliations and compliance standards.
• Excellent verbal and written business communication skills.
• Ability to adapt to a dynamic work environment, solve problems, and make decisions with minimal oversight.
• Demonstrated initiative, commitment, and ability to work under pressure and meet tight deadlines.
• Ability to collaborate effectively across teams and manage multiple priorities.

Requirements

• If you will be working at home occasionally or permanently, the internet connection must be obtained through a cable broadband or fiber optic internet service provider with speeds of at least 10Mbps download/5Mbps upload.

Benefits

• Comprehensive range of benefits focused on supporting your whole health.
• Health-related benefits including medical, vision, dental, and well-being and behavioral health programs starting on day one of employment.
• 401(k) plan.
• Company paid life insurance.
• Tuition reimbursement.
• A minimum of 18 days of paid time off per year and paid holidays.