Quality Audit Analyst

Quality Audit Analyst Band 2

YOUR JOB

As a Quality Audit Analyst you play a key role in safeguarding operational excellence across service delivery teams. You will be responsible for conducting quality audits reviewing case accuracy identifying process gaps and ensuring adherence to internal procedures regulatory guidelines and customer commitments.

You will provide actionable feedback to team leaders and staff support continuous improvement and contribute to building a culture of quality compliance and consistency across Operations.

This role acts as a bridge between frontline teams supervisors and quality leaders by bringing insight evidence-based recommendations and rootcause analysis into daily operations.

KEY RESPONSIBILITIES

Quality Review & Audit Execution

• Conduct routine and targeted audits across operational workstreams (e.g. Claims Eligibility Admin Customer Service Client Support).
• Assess accuracy completeness compliance and alignment to SOPs and regulatory requirements.
• Review system entries documentation case handling and communication quality.
• Ensure audit scoring is objective consistent and aligned with the quality framework.

Insights Feedback & Coaching Support

• Provide clear constructive audit feedback to team members and supervisors.
• Highlight highrisk errors and recurring themes that require escalation.
• Support team leaders in delivering quality coaching sessions.
• Maintain accurate audit logs and records for reporting & governance.

Risk & Compliance Support

• Identify potential compliance gaps regulatory breaches or quality risks.
• Escalate critical findings promptly to supervisors and Quality leads.
• Support adherence to audit requirements for internal control risk management and governance processes.

Continuous Improvement

• Recommend improvements to processes documentation and training materials.
• Assist in revising SOPs or workflows when audit trends indicate the need for change.
• Identify opportunities for automation to improve process quality.
• Participate in miniprojects or working groups aimed at service improvement.

Data & Reporting

• Define appropriate outcome-based metrics for aligned process
• Compile quality metrics error trends and monthly/quarterly dashboards.
• Support rootcause analysis to identify systemic issues.
• Contribute to MOR input audit summaries and performance packs where required.

CrossTeam Collaboration

• Work closely with supervisors trainers SMEs transitions and QA colleagues to maintain consistent quality standards.
• Support readiness for new releases process changes training classes or quality framework updates.
• Participate in calibration sessions to ensure fairness and consistency of audit scoring.

YOUR PROFILE

• Minimum 3-5 years experience in an operations or qualityrelated role.
• Strong understanding of operational processes (claims eligibility admin or service preferred).
• Good working knowledge of operational systems and tools (e.g. workflow systems QA tools CRM platforms Excel).
• Excellent attention to detail and accuracy.
• Strong analytical capability with ability to interpret data and identify trends.
• Clear communicator capable of giving balanced and constructive feedback.
• Ability to prioritise workload manage deadlines and work independently.
• Strong problemsolving skills and processdriven mindset.
• Customerfocused with a commitment to driving quality and service improvement.
• Fluent in English; additional languages are an advantage.
• Demonstrates integrity fairness and objectivity in audit assessment.

KEY COMPETENCIES

• Quality Orientation Focuses on compliance accuracy and errorfree output.
• Analytical Thinking Uses data patterns and rootcause reasoning.
• Attention to Detail Diligent and precise in reviewing casework.
• Collaboration Builds constructive relationships with supervisors and staff.
• Communication Provides clear written and verbal audit feedback.
• Time Management Manages audit volumes and deadlines effectively.
• Process Discipline Follows frameworks SOPs and governance standards.
• Continuous Improvement Mindset Identifies improvement opportunities.
• Objectivity & Fairness Ensures unbiased audit scoring.
• Customer Focus Drives outcomes that protect customer experience.

About The Cigna Group