Issue Resolution Lead Analyst, Individual Dental Operations - Cigna Healthcare - Remote

Summary The Operations Lead Analyst is a key contributor within Stand-Alone Dental Operations responsible for researching and resolving complex, sensitive, and escalated customer issues received through multiple intake channels. This role manages assigned cases from intake through resolution, ensuring that work is completed accurately, timely, and in accordance with internal standards and applicable regulatory requirements. The Operations Lead Analyst collaborates with Operations, Compliance, Customer Service, and business support partners to resolve federal and state-based marketplace inquiries, Department of Insurance matters, Senior Leadership escalations, and other complex customer concerns. The role also identifies trends, documents findings, recommends process improvements, and provides technical guidance to team members. Core Accountabilities and Responsibilities Customer Issue and Escalation Management Manage assigned customer issue intake queues by tracking, prioritizing, researching, documenting, resolving, and closing cases in accordance with established requirements. Research and resolve complex or sensitive customer issues, complaints, Senior Leadership inquiries, and Department of Insurance matters. Support customer inquiries received through federal exchange and state-based marketplace channels. Evaluate customer needs, determine appropriate next steps, and develop effective resolutions using sound judgment, technical knowledge, and established business processes. Communicate findings, decisions, and resolutions clearly and professionally to customers, business partners, and leadership. Maintain complete and accurate case documentation, including research performed, conclusions reached, actions taken, and final outcomes. Regulatory Compliance and Case Controls Monitor case activity and turnaround times to ensure compliance with applicable regulatory and internal requirements. Identify and escalate potential compliance risks, missed dependencies, or barriers that could affect timely and accurate case resolution. Apply current marketplace, dental-product, and customer-issue resolution requirements when researching and resolving assigned matters. Protect customer information and follow applicable privacy, security, documentation, and records-management requirements. Support requests for case information, documentation, or subject matter expertise related to audits, compliance reviews, and operational inquiries. Analysis and Process Improvement Analyze customer issues and case activity to identify recurring themes, operational trends, process gaps, and emerging risks. Document findings and recommend practical improvements to customer service processes, workflows, controls, communications, or supporting documentation. Participate in operational projects, business testing, and process-improvement initiatives supporting Stand-Alone Dental Operations. Provide frontline observations and subject matter expertise to help improve customer experience and operational effectiveness. Support the validation of process changes and confirm that implemented solutions address the identified business need. Team and Cross-Functional Support Serve as a technical resource for team members by answering questions, sharing knowledge, and providing guidance on complex cases and established processes. Partner with Operations, Compliance, Customer Service, and business support teams to research issues and coordinate timely resolutions. Build and maintain effective working relationships with matrix partners across the organization. Share relevant trends, risks, and lessons learned to strengthen team knowledge and improve consistency. Independently manage assigned workload, competing priorities, and time-sensitive requests in a fast-paced operational environment.

Required Minimum of three years of healthcare insurance business experience in areas such as benefits, eligibility, claims, customer service, contact center