Position Summary
The Individual Dental Premium, Enrollment and Reconciliation Lead Analyst supports premium processing, enrollment operations, and financial reconciliation for on- and off-Marketplace Individual Dental business. This role partners with vendors and internal matrix partners to research and resolve data discrepancies across multiple systems, maintain the accuracy and consistency of enrollment and financial information, and provide clear reporting on the status of premium, enrollment, and reconciliation activities.
The Lead Analyst serves as a senior operational resource and subject matter expert, using data analysis, cross-functional coordination, and process improvement capabilities to support accurate financial outcomes, effective operational controls, and reliable end-to-end data flows. This is an individual-contributor role with no direct people-management responsibilities.
Core Accountabilities & Responsibilities
Premium Operations
- Support daily premium operations for Individual Dental, including identifying, researching, and resolving metric gaps across vendor and internal systems.
- Analyze the effectiveness of premium billing, collection, revenue capture, and reporting processes and recommend sustainable, repeatable, and measurable improvements.
- Support business initiatives involving the evaluation of requirements and development of procedures and policy solutions for complex premium-related operational needs.
- Partner with government and Individual Marketplace stakeholders to support compliance with requirements governing subsidy-payment processing and resolve identified gaps.
- Support the reconciliation and payment of vendor purchase orders and invoices associated with premium operations.
- Execute assigned Sarbanes-Oxley controls and maintain appropriate documentation to support ongoing control testing.
Enrollment Operations
- Partner with vendors and internal stakeholders to establish and maintain end-to-end processes for enrollment-data analysis, reconciliation, and discrepancy resolution.
- Support daily, weekly, and monthly enrollment reconciliation across multiple systems and internal and external partners.
- Research transactional errors and enrollment discrepancies, determine contributing factors, and coordinate appropriate resolution.
- Analyze discrepancies identified through monthly reconciliation among the Healthcare Marketplace, affinity partners, and enrollment and billing vendors.
- Coordinate with vendor, enrollment, and Healthcare Marketplace liaison teams to report, track, and resolve enrollment-data discrepancies.
- Use data-driven analysis to reduce disconnected or inconsistent metrics and improve enrollment-process efficiency.
Financial Reconciliation and Reporting
- Support monthly, quarterly, and annual financial-close activities for Individual Dental, including vendor and governmental reconciliation.
- Research, explain, and support the resolution of reconciliation discrepancies affecting enrollment and financial reporting.
- Develop weekly, monthly, quarterly, and annual reporting, including premium-error forecasts and actual results compared with forecasts.
- Analyze the validity of enrollment and financial information supporting Healthcare Exchange user fees, cost-share reduction impacts, and applied premium tax credit payments.
- Summarize findings and provide recommendations to support accurate financial and operational outcomes.
- Partner with Finance and Accounting to coordinate reporting and resolve financial-data discrepancies.
- Serve as a procedural and workflow subject matter expert for Individual Dental reconciliation processes.
Operational and Technology Partnership
- Partner with operational and technology teams to develop and implement business processes and technology solutions supporting oversight of Dental billing, enrollment, and financial management.
- Communicate the status of reconciliation activities, discrepancies, and resolution efforts to matrix partners and leadership.
- Build and maintain cross-functional relationships that support end-to-end data accuracy, transparency, and timely issue resolution.
- Identify future program and operational needs and contribute to business cases supporting process or technology changes.
- Serve as a project resource and subject matter expert for Individual Dental and enterprise initiatives, as assigned.
- Support corporate and statutory audits by providing documentation and analysis related to premium, enrollment, and reconciliation activities.
Process Improvement and Issue Resolution
- Analyze complex data and operational results to identify trends, control gaps, recurring discrepancies, and improvement opportunities.
- Develop and recommend contingency plans and practical solutions when operational issues arise.
- Raise questions, risks, issues, and improvement opportunities with appropriate partners and leaders.
- Manage competing priorities while maintaining urgency, accuracy, and accountability for assigned deliverables.
- Work independently and collaboratively to drive measurable improvements in operational performance and data quality.
Qualifications / Knowledge
- Bachelor’s degree in Business, Finance, Healthcare Administration, or a related discipline preferred. Equivalent professional experience may be considered.
- At least three years of business experience in healthcare operations, financial reconciliation, enrollment management, or a related discipline.
- Experience supporting Individual Dental or Individual and Family Plan operations strongly preferred.
- Knowledge of premium billing, enrollment processing, financial reconciliation, discrepancy management, and operational reporting.
- Understanding of operational controls, audit documentation, and cross-functional issue resolution.
- Strong analytical and problem-solving skills, with the ability to interpret complex information and develop actionable recommendations.
- Strong written and verbal communication skills, including the ability to clearly communicate findings to cross-functional partners and leadership.
- Demonstrated ability to organize work, manage competing priorities, and drive results in a dynamic environment.
- Ability to work independently while effectively collaborating with vendors, peers, matrix partners, and leaders.
- Strong influencing and matrix-management capabilities preferred.
- Proficiency with Microsoft Excel and Access.
- Working knowledge of Microsoft Word, PowerPoint, and Visio preferred.
- Experience with relational databases, XML, reconciliation tools, and enrollment or billing vendor systems preferred.
If you will be working at home occasionally or permanently, the internet connection must be obtained through a cable broadband or fiber optic internet service provider with speeds of at least 10Mbps download/5Mbps upload.For this position, we anticipate offering an annual salary of 62,600 - 104,300 USD / yearly, depending on relevant factors, including experience and geographic location.
This role is also anticipated to be eligible to participate in an annual bonus plan.
At The Cigna Group, you’ll enjoy a comprehensive range of benefits, with a focus on supporting your whole health. Starting on day one of your employment, you’ll be offered several health-related benefits including medical, vision, dental, and well-being and behavioral health programs. We also offer 401(k), company paid life insurance, tuition reimbursement, a minimum of 18 days of paid time off per year, paid holidays, and leaves of absence. For more details on our employee benefits programs, click here.
About Cigna Healthcare
Cigna Healthcare, a division of The Cigna Group, is an advocate for better health through every stage of life. We guide our customers through the health care system, empowering them with the information and insight they need to make the best choices for improving their health and vitality. Join us in driving growth and improving lives.
Qualified applicants will be considered without regard to race, color, age, disability, sex, childbirth (including pregnancy) or related medical conditions including but not limited to lactation, sexual orientation, gender identity or expression, veteran or military status, religion, national origin, ancestry, marital or familial status, genetic information, status with regard to public assistance, citizenship status or any other characteristic protected by applicable equal employment opportunity laws.
If you need a reasonable accommodation to complete the online application process, please email seeyourself@thecignagroup.com for assistance. Please note that this email inbox is dedicated to accommodation requests only and cannot provide application updates or accept resumes.
The Cigna Group has a tobacco-free policy and reserves the right not to hire tobacco/nicotine users in states where that is legally permissible. Candidates in such states who use tobacco/nicotine will not be considered for employment unless they enter a qualifying smoking cessation program prior to the start of their employment. These states include: Alabama, Alaska, Arizona, Arkansas, Delaware, Florida, Georgia, Hawaii, Idaho, Iowa, Kansas, Maryland, Massachusetts, Michigan, Nebraska, Ohio, Pennsylvania, Texas, Utah, Vermont, and Washington State.
Qualified applicants with criminal histories will be considered for employment in a manner consistent with all federal, state and local ordinances.
