Senior Manager, Individual Dental Operating Effectiveness - Cigna Healthcare - Remote

Cigna Healthcare•Tennessee Work at Home, TN

2d•Remote

About The Position

The Operations Senior Manager, Operating Effectiveness serves as the senior leader responsible for the operational governance framework supporting the Individual Dental business. This role provides leadership across Quality Assurance, Knowledge Management, Operations Compliance & Risk Management, Vendor Management & Governance, and Testing functions to ensure operational integrity, regulatory adherence, business readiness, and sustainable operational performance. The Operations Senior Manager establishes governance processes, quality standards, operational controls, testing strategies, vendor oversight frameworks, and compliance monitoring activities that protect the business, improve performance, and enable successful execution of business objectives. This role serves as a strategic partner to Operations, Product, Technology, Legal, Compliance, Finance, and PMO leadership to strengthen operational effectiveness and support long-term business success.

Requirements

Bachelor's Degree required
8+ years of progressive leadership experience in operational excellence, quality assurance, compliance, risk management, business operations, healthcare operations, or related disciplines.
Demonstrated experience leading quality, governance, compliance, testing, operational effectiveness, or risk management functions.
Strong understanding of operational controls, audit methodologies, risk management frameworks, governance practices, and compliance oversight.
Experience managing complex vendor relationships and performance governance programs.
Knowledge of testing methodologies, operational readiness practices, and implementation support activities.
Proven ability to drive continuous improvement initiatives and organizational change.
Experience working in highly regulated environments.
Strong analytical, communication, stakeholder management, and leadership skills.
Experience leading teams in matrixed organizations preferred.

Nice To Haves

Experience leading teams in matrixed organizations

Responsibilities

Establish and maintain governance frameworks that promote accountability, transparency, and operational discipline across the Individual Dental organization.
Develop operational controls, monitoring processes, and oversight mechanisms that support business performance and organizational effectiveness.
Lead governance forums, operational reviews, and performance discussions that provide leadership visibility into operational health, emerging risks, and opportunities.
Partner with business leaders to ensure operational practices remain aligned with strategic objectives, regulatory expectations, and enterprise standards.
Drive resolution of operational issues through disciplined governance, root-cause analysis, and corrective action planning.
Lead quality assurance programs that evaluate operational performance, customer interactions, adherence to procedures, and service delivery effectiveness.
Establish quality standards, audit methodologies, scorecards, and monitoring processes across operational functions.
Analyze quality trends and identify opportunities for performance improvement, training, coaching, and process enhancements.
Ensure consistent application of quality standards across internal operations and vendor-supported functions.
Partner with operational leaders to implement corrective action plans and performance improvement initiatives.
Lead enterprise knowledge management activities supporting operational consistency and business readiness.
Establish standards for policies, procedures, work instructions, job aids, and operational documentation.
Ensure operational knowledge assets remain current, accurate, accessible, and aligned with regulatory and business requirements.
Partner with business leaders to support implementation of new products, systems, processes, and operational changes.
Drive organizational readiness through effective documentation, communication, and knowledge transfer strategies.
Lead operational compliance activities supporting adherence to regulatory, contractual, operational, and business requirements.
Establish monitoring and oversight processes that identify operational risks, compliance gaps, and process vulnerabilities.
Partner with Legal, Compliance, Audit, Privacy, and Risk Management teams to support governance and oversight activities.
Coordinate responses to audits, operational assessments, compliance reviews, and business control evaluations.
Develop and maintain operational controls designed to mitigate risk, strengthen business integrity, and promote regulatory compliance.
Serve as the business leader responsible for governance of strategic vendors supporting the Individual Dental organization.
Establish vendor oversight frameworks that ensure contractual obligations, service levels, quality standards, and business expectations are achieved.
Lead vendor performance reviews, operational business reviews, escalation management, and continuous improvement efforts.
Monitor vendor compliance with operational requirements and performance expectations.
Partner with Procurement, Legal, Operations, and Finance teams to support effective vendor relationships and business outcomes.
Lead business testing functions supporting system implementations, product launches, operational changes, and strategic initiatives.
Establish testing methodologies, governance standards, and quality controls that ensure successful business implementation.
Ensure business requirements are validated through effective user acceptance testing, operational validation, and readiness assessments.
Partner with Technology, Product, Operations, and PMO teams to coordinate testing activities and implementation readiness.
Identify and mitigate operational risks associated with system, process, or business changes.
Lead initiatives focused on improving operational efficiency, effectiveness, quality, and customer outcomes.
Utilize performance data, audit findings, operational metrics, and stakeholder feedback to identify improvement opportunities.
Facilitate root-cause analysis and corrective action planning for operational issues and performance gaps.
Promote continuous improvement methodologies and best practices throughout the organization.
Support business transformation efforts through operational optimization and change adoption activities.
Lead and develop a high-performing team across quality assurance, knowledge management, compliance, risk management, testing, and vendor governance functions.
Foster a culture of accountability, continuous improvement, operational discipline, and customer focus.
Build organizational capabilities that support long-term operational excellence and business sustainability.
Provide coaching, mentoring, and professional development opportunities for team members.
Promote collaboration and partnership across operational, technical, and business teams.
Lead day-to-day operations across the Individual Dental business, ensuring operational performance, service delivery, and customer outcomes achieve defined business objectives.
Establish operational priorities and execution plans that support business goals, customer experience objectives, and business requirements.
Monitor operational performance and implement corrective actions to address service disruptions, performance gaps, operational risks, and emerging business issues.
Serve as the operational leader during enrollment periods, business events, and significant operational incidents.
Ensure operational readiness and execution for all business initiatives impacting customer, provider, billing, enrollment, or servicing functions.
Provide leadership and oversight for enrollment operations, including applications, onboarding, renewals, terminations, eligibility maintenance, and enrollment integrity.
Direct billing and premium administration functions to ensure accurate invoicing, premium collection, financial reconciliation, and customer account management.
Oversee reconciliation activities to ensure financial accuracy and timely resolution of operational discrepancies.
Establish operational controls and monitoring processes that support operational accuracy and business performance.
Partner with Finance and enterprise business teams to resolve operational issues impacting financial outcomes.
Lead customer operations activities, including service delivery, contact center performance, escalations, complaint management, and issue resolution.
Ensure customer inquiries and operational issues are resolved efficiently while maintaining high levels of service quality and customer satisfaction.
Monitor service performance metrics and implement improvement plans that enhance operational outcomes.
Partner with internal and external service organizations to ensure a consistent customer experience across all interaction channels.
Serve as the escalation point for significant operational and customer service issues.
Lead operational reporting and business intelligence functions supporting the Individual Dental business.
Establish performance scorecards, dashboards, and reporting frameworks that provide visibility into operational health and business performance.
Monitor key operational metrics and trends, identifying opportunities to improve performance, productivity, and customer outcomes.
Deliver operational insights and recommendations that support leadership decision-making.
Support executive reporting, business reviews, forecasting activities, and operational planning processes.
Provide business oversight of Dental Claims operations performed by Enterprise Operations organizations.
Partner with enterprise operational leaders to ensure claims performance, quality, accuracy, turnaround times, and customer outcomes meet business expectations.
Monitor claims-related performance metrics and drive resolution of operational issues impacting customers, providers, or business results.
Collaborate with Enterprise teams to improve operational processes, service levels, and member experience outcomes.
Represent Individual Dental operational priorities within enterprise operational forums and planning activities.
Lead and develop a high-performing team across customer operations, operational support, reporting, and business operations functions.
Establish clear performance expectations and accountability measures that drive operational results.
Foster a culture of operational excellence, customer focus, accountability, continuous improvement, and innovation.
Support talent development, succession planning, and workforce readiness activities.
Build strong partnerships across business, technology, operations, and vendor organizations.