Quality Review and Audit Lead Analyst, Individual Dental Operations - Cigna Heal

Position Summary

The Quality Review and Audit Lead Analyst supports the quality assurance and audit functions within Individual Dental Operations. This role conducts and coordinates internal and vendor quality reviews, analyzes audit results, develops reporting, identifies operational trends and risks, and works with business partners to improve processes, controls, and customer outcomes.

The Lead Analyst applies advanced knowledge of quality assurance, auditing, operational processes, and data analysis to complex assignments requiring independent judgment. The role supports daily audit operations, evaluates complex findings, maintains audit procedures and supporting documentation, and provides technical guidance to audit professionals and business partners.

This position also uses audit data and operational insights to identify compliance risks, reporting gaps, process deficiencies, and opportunities for continuous improvement, cost efficiency, and an enhanced customer experience.

Core Accountabilities and Responsibilities
Quality Review and Audit Execution

- Conduct quality reviews and audits of internal operations and vendor-supported processes to evaluate adherence to established requirements, procedures, and controls.

- Support daily audit activities, including review planning, case selection, evidence collection, documentation, analysis, and reporting.

- Evaluate complex audit findings independently, engaging business owners or subject matter experts when additional technical interpretation is required.

- Maintain complete and accurate audit documentation that supports findings, conclusions, and recommended actions.

- Monitor audit activities and deliverables to ensure applicable regulatory turnaround requirements and internal expectations are met.

- Support the collection and organization of evidence required for enterprise, regulatory, internal, or external audits.

- Identify potential compliance concerns and escalate material findings or risks to the appropriate business owner.

- Support calibration activities among internal audit professionals, operational teams, and vendor partners to promote consistent application of audit standards.

Quality Reporting and Analytics

- Collect, validate, analyze, and summarize audit and quality data using approved systems and analytical tools.

- Develop and maintain reports, dashboards, and supporting analyses that provide visibility into quality performance, audit findings, trends, and improvement opportunities.

- Ensure recurring quality reports are accurate, timely, and aligned with the needs of operational leaders and business partners.

- Compare quality results over time and evaluate progress against corrective actions, process improvements, and broader quality initiatives.

- Identify patterns, recurring findings, emerging risks, and potential reporting gaps within audit and operational data.

- Communicate analytical findings clearly to Quality Assurance, Operations, vendor, and business partners.

- Partner with subject matter experts, team leads, and supervisors to define new data-collection requirements and address reporting gaps.

- Develop new tracking and reporting capabilities as needed to support operating-model changes, business growth, or expansion.

Findings, Risk, and Corrective-Action Support

- Analyze audit findings to determine potential root causes, business impacts, customer impacts, and compliance risks.

- Distinguish isolated errors from recurring or systemic process issues requiring broader business attention.

- Provide audit data and supporting evidence to business owners responsible for developing corrective or preventive actions.

- Monitor identified issues and support reporting on remediation progress, recurring findings, and unresolved risks.

- Proactively identify potential future risks, process weaknesses, or control gaps based on audit results and operational trends.

- Engage appropriate business partners when findings r