Senior Supervisor, Individual Dental Operations - Cigna Healthcare - Remote

Position Summary

The Quality Review and Audit Senior Supervisor is responsible for leading quality assurance, audit support, operational oversight, and customer escalation functions supporting the Individual Dental business. This role ensures operational processes, customer interactions, vendor activities, and business practices are executed in accordance with established procedures, regulatory requirements, and quality standards while delivering effective resolution of complex customer concerns and business issues.

The Quality Review and Audit Senior Supervisor leads a team responsible for quality monitoring, audit activities, customer issue intake, complaint management, regulatory inquiries, and escalation resolution. This leader partners closely with Operations, Compliance, Vendor Management, Customer Operations, Enterprise teams, and business stakeholders to identify operational risks, improve customer outcomes, strengthen controls, and support continuous improvement initiatives across the Individual Dental organization.

Lead quality assurance activities supporting operational excellence across the Individual Dental business. Establish and maintain quality monitoring programs, audit methodologies, evaluation standards, and reporting processes. Review operational performance, customer interactions, vendor activities, and business processes to assess adherence to established standards and requirements. Analyze quality trends and identify opportunities to improve operational effectiveness, customer outcomes, and business performance. Partner with operational leaders to implement corrective actions, process improvements, and performance enhancement initiatives.

Lead a team responsible for intake, triage, tracking, investigation, and resolution of customer concerns received through multiple channels. Oversee management of Department of Insurance inquiries, executive escalations, Exchange-related requests, Access to Care concerns, complaints, grievances, and other complex customer issues. Ensure customer concerns are documented, prioritized, investigated, resolved, and communicated appropriately. Provide leadership support on highly sensitive, complex, or high-visibility customer matters.

Drive root cause identification and partner with business stakeholders to prevent recurring customer issues.

Support internal, external, enterprise, and regulatory audit activities impacting the Individual Dental business. Coordinate collection, validation, and organization of audit evidence, supporting documentation, and business responses. Assist in development and maintenance of audit programs, monitoring activities, and corrective action tracking. Identify control gaps, operational risks, and process deficiencies through quality reviews, audits, and escalation trends. Partner with business stakeholders to ensure remediation activities are completed and documented appropriately.

Monitor activities affecting compliance with applicable Federal Exchange, State-Based Exchange, Department of Insurance, and business requirements. Ensure customer inquiries and issue resolution activities meet established turnaround expectations and business standards. Support implementation of operational requirements resulting from regulatory or business changes. Partner with Compliance and operational teams to address identified compliance concerns or operational risks. Monitor trends and emerging issues that may impact regulatory performance or customer experience.

Analyze operational data,…