[Hiring] Quality Review and Audit Senior Analyst @Cigna Healthcare

Role Description

The Quality Review and Audit Senior Analyst conducts quality reviews and audits of internal operations and vendor-supported activities within Individual Dental Operations. This role evaluates compliance with established procedures, quality standards, business requirements, and applicable regulatory expectations.

The Senior Analyst independently manages routine and complex audit assignments, documents and communicates findings, analyzes quality results, and identifies trends, process gaps, and improvement opportunities. The role serves as an experienced technical resource for Quality Review and Audit team members and supports calibration, reporting, onboarding, and process-improvement activities.

This position works closely with Operations, Compliance, vendor partners, and other business teams to promote consistent execution, strengthen operational quality, and improve customer outcomes.

Qualifications

• Three or more years of relevant experience in healthcare operations, customer service, benefits, eligibility, claims, contact center operations, quality assurance, or auditing.
• Previous experience conducting quality reviews, operational audits, transaction reviews, or comparable control activities.
• Demonstrated ability to independently complete routine and complex audit assignments.
• Experience applying audit criteria, scoring guidelines, procedures, and business requirements consistently.
• Ability to identify trends and communicate findings using clear examples and supporting evidence.
• Strong analytical, problem-solving, and decision-making skills.
• Strong attention to detail and commitment to accurate audit documentation.
• Ability to manage multiple assignments and priorities in a fast-paced environment.
• Strong written and verbal communication skills.
• Ability to provide technical support and guidance without formal supervisory authority.
• Proficiency with Microsoft Office applications, particularly Microsoft Excel.
• Ability to work collaboratively with internal teams, business partners, and vendor organizations.

Requirements

• Experience supporting Individual Dental, Individual and Family Plans, or another regulated healthcare operation.
• Knowledge of federal and state regulatory requirements applicable to the supported business.
• Experience with call monitoring, transaction auditing, claims review, or operational system reviews.
• Experience analyzing quality trends or preparing audit summaries and reports.
• Experience participating in calibration sessions or supporting audit-scoring consistency.
• Experience assisting with onboarding, peer coaching, or technical training.
• Experience supporting corrective actions, quality projects, or process-improvement initiatives.
• Experience with OnBase, Microsoft Access, or comparable audit and reporting tools.
• Ability to travel occasionally based on business needs.

Benefits

• Annual salary of 58,400 - 97,400 USD / yearly, depending on relevant factors, including experience and geographic location.
• Eligibility to participate in an annual bonus plan.
• Comprehensive range of benefits, including medical, vision, dental, and well-being and behavioral health programs.
• 401(k) and company paid life insurance.
• Tuition reimbursement.
• A minimum of 18 days of paid time off per year, paid holidays, and leaves of absence.