Quality Review and Audit Lead Analyst - Express Scripts - Remote

The Cigna Group

1d•Remote

About The Position

The Quality Review and Audit Lead Analyst supports Quality Control, Audit, and testing initiatives across client implementations, benefit changes, and ongoing business activities. This role focuses on executing defined test plans, validating benefit configuration and data accuracy, documenting defects, and supporting testing timelines in alignment with established methodologies and guidance. Applying analytical thinking, attention to detail, and foundational subject matter knowledge, the Analyst helps identify issues, validate expected outcomes, and support accurate delivery of client and regulatory requirements. Working in a collaborative, fast-paced environment, the Analyst partners with implementation, account, operations, and product teams—under the direction of Advisors and Senior Advisors—to ensure test execution aligns with defined requirements and business objectives. The role also contributes to operational readiness and continuous improvement by following established procedures, documenting findings, and by participating in lessons learned and process improvement efforts. The Analyst supports multiple Lines of Business, including HealthPlan, Medicare, Medicaid, Exchange, Commercial, DoD, and Cigna, and may participate in client-facing activities with appropriate oversight while continuing to build expertise across testing methodologies, business processes, and lines of business.

Requirements

Bachelor’s degree required, with 1+ years of experience in operations, benefits/clinical, claims processing, testing, quality assurance, audit, or a related role preferred – or– 5+ years of related experience
Basic knowledge of healthcare benefits and/or claims processing preferred
Clinical, pharmacy, or healthcare-related background preferred
Ability to follow testing instructions, document findings, and meet assigned deadlines
Willingness to learn multiple Lines of Business, including HealthPlan, Medicare, Medicaid, Exchange, Commercial, DoD, and Cigna
Proficiency in Microsoft Excel, Word, Outlook, PowerPoint, and SharePoint
Internet connection must be obtained through a cable broadband or fiber optic internet service provider with speeds of at least 10Mbps download/5Mbps upload.

Responsibilities

Execute assigned testing activities for implementations, benefit changes, and business initiatives following defined test plans and procedures
Perform data validation and test case execution to confirm accuracy, completeness, and alignment with expected setup
Support test preparation activities, including test data creation and validation
Assist in maintaining testing schedules and meeting expected completion dates
Identify and document testing defects, discrepancies, and observations clearly and accurately
Track issues and support escalation to Advisors or project leads as needed
Retest fixes and validate resolutions to confirm expected outcomes
Maintain detailed documentation of testing results and findings
Follow established testing processes, quality controls, and documentation standards
Participate in lessons learned discussions and contribute suggestions for process enhancements
Support updates to testing documentation, job aids, and reference materials
Assist with pilot initiatives, special projects, and ad hoc testing efforts as assigned
Participate in project meetings, team discussions, and working sessions
Collaborate with peers and cross-functional partners to support testing deliverables
Actively build knowledge of benefits, configuration, and testing methodologies
Seek and incorporate feedback to support skill development and readiness for increased responsibility