Quality Review and Audit Senior Analyst, Individual Dental Operations - Cigna Healthcare - Remote

Summary 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. Core Accountabilities and Responsibilities Quality Review and Audit Execution Conduct quality reviews and audits of customer interactions, operational transactions, and supporting system activity. Evaluate work against established procedures, quality standards, scoring guidelines, business requirements, and applicable regulatory expectations. Independently manage assigned audits from case selection and evidence review through scoring, documentation, and completion. Perform routine and complex reviews involving internal operations and vendor-supported processes. Maintain accurate and complete audit records that support audit scores, findings, and conclusions. Identify cases requiring additional review, calibration, or subject matter expertise. Monitor assigned work to ensure audit requirements and established completion expectations are met. Support internal, vendor, regulatory, or third-party audit activities by gathering documentation, reviewing selected cases, responding to questions, and validating relevant information. Findings and Quality Analysis Analyze audit results to identify recurring errors, quality trends, process gaps, and potential operational risks. Distinguish isolated errors from patterns that may require broader business review or corrective action. Provide clear examples and supporting evidence when communicating identified trends or concerns. Prepare summaries and initial analyses of audit results for review by Quality Assurance leadership. Assist with the development and distribution of recurring quality and audit reporting. Compare audit findings across employees, processes, vendors, or review periods when appropriate data is available. Escalate significant quality, compliance, system, or process concerns to the Lead Analyst or Quality Assurance leadership. Recommend areas for additional monitoring, calibration, training, or process review based on audit evidence. Calibration and Audit Consistency Participate in internal and vendor calibration sessions to support consistent interpretation of audit standards and scoring guidelines. Independently identify appropriate cases for calibration when questions or potential inconsistencies arise. Serve as backup to the Lead Analyst for internal calibration activities. Explain scoring decisions and provide supporting evidence during calibration discussions. Help identify unclear audit criteria, scoring guidance, or procedural requirements requiring clarification. Apply calibration decisions consistently to subsequent audit work. Share calibration outcomes and relevant guidance with team members as directed. Technical and Team Support Serve as an experienced resource for Quality Review and Audit team members by answering technical questions and providing guidance on established procedures. Support less-experienced team members with audit methodology, system navigation, documentation, and scoring questions. Assist with onboarding and job-shadowing activities for new Quality Review and Audit employees. Help reinforce consistent audit practices through knowledge