Healthcare

At Protiviti, we know healthcare. Our global reach continues to expand at a rapid pace as we serve leading healthcare organisations amid accelerating change. We know industry changes that are imminent and their drivers. And, we know how to advise our clients to effectively address industry changes to best manage, protect and create substantial value in their healthcare delivery systems. Our team of experienced professionals and our Healthcare Center of Excellence are your resources for understanding and managing the multitude of changes and risks affecting healthcare. Whether your organisation’s chief concern is payment reform, regulatory compliance, revenue growth, cost management, cybersecurity or digital transformation, Protiviti is here for you.

Protiviti Healthcare also serves the Pharmaceutical and Life Sciences Industry. Learn more here.

Challenges and Opportunities facing the Healthcare Industry

Healthcare organisations face complex challenges in an ever-evolving environment. Our healthcare collection brings unique insights and expert guidance to help payer, provider, and life sciences leaders make better decisions, manage inherent challenges and risks, and make long-term transformational change.

Sectors we serve

Protiviti's healthcare industry team helps payer and provider leaders make better decisions by managing the risks they face today, as well as illuminating the risks and unforeseen consequences inherent in their strategies for future growth and opportunity

Healthcare Providers

Protiviti brings deep industry knowledge and skills to help healthcare provider organisations manage risks and maintain their financial health. Our tailored solutions span clinical excellence, digital & advanced analytics, enterprise applications/ ERP modernisation, financial & operational performance, information technology & cybersecurity, innovation, mergers & acquisitions, next-gen internal audit, revenue integrity, risk & compliance and other top provider concerns.

 

Healthcare Payers

Specialise in helping health plans and PBMs across Medicare, Medicaid, and commercial lines of business operationalise and execute solutions to enhance business performance and drive sustainable growth. Whether we are assisting with strategic planning, revenue enhancement, cost savings, or process improvement initiatives, we apply innovation, collaboration, and technology acumen across your organisation.

 

Our services for Healthcare Organisations:

Healthcare is a strategic industry at Protiviti with dedicated professionals and a Healthcare Center of Excellence that is organised to innovate industry-specific solutions with a primary goal of becoming a mission-critical strategic partner to each of the organisations we serve.

Protiviti’s world-class internal audit (IA) services provide effective insight and confidence to leaders that their organisations can meet the demands of the ever-changing business environment.  Management is leveraging IA more than ever as a strategic resource to provide guidance based on broad and deep skill sets and perspectives; analytical and digital capabilities; and internal knowledge of operations, strategic goals, and risk and control structures.  Our IA services help ensure that healthcare organisations become more innovative and explore new technologies, identify and mitigate emerging risks, develop creative solutions to address complex business challenges, and encourages best practices to enhance business functions. Healthcare Internal Audit and Financial Advisory services include:

  • IA Assurance and Advisory Services
  • IT Audits
  • Next-Gen Auditing & Analytics
  • IA Program Assessments & Benchmarking
  • Risk Assessment & Audit Plan Development

Protiviti provides solutions to help providers and payers ensure they have a robust, effective compliance program to prevent and detect instances and events of legal and regulatory violations. Healthcare Risk & Compliance services includes:

  • Co-sourcing/outsourcing
  • Assessment & Remediation
  • Audits & Investigations
  • Compliance Program Effectiveness
  • Compliance Projects
  • Compliance Risk Assessments
  • Enterprise Risk Management
  • Independent Review Organisations
  • Interim Compliance Officer / Supplemental Staffing

Protiviti provides agile services through a unique, blended model of flexible staffing services and consulting expertise whether your need is project, program, or skill based in nature.  From coordination and management of IT projects to full outsourcing of labor-intensive technology support and implementation services, we help you thrive amid the numerous challenges  in the following areas so you can focus on your strategic initiatives. Healthcare Technology Consulting services include:

  • Cloud Solutions
  • Compliance and Frameworks
  • Custom Development Services
  • Cybersecurity
  • Data and Advanced Analytics 
  • Emerging Technologies 
  • Enterprise Application Solutions
  • Managed / Outsourced Solutions
  • Technology Strategy and Operations

Financial & Operational Performance services increase enterprise value by transforming business processes and driving sustainable change. The best Finance, Revenue Cycle, and Performance Management professionals deliver proven results in challenging environments by effectively leveraging technology and leading practices, using tested and proven program management techniques and capabilities, and bringing an intense focus on change management. Concurrently, Protiviti and Robert Half partner to share the workload/burden with our clients to address performance or project issues in key business functions while also filling operational roles in a unique arrangement, using proven results-oriented professionals.  Healthcare Business Performance Improvement services include:

  • Clinical Excellence
  • Finance Process Improvement
  • Managed Services
  • Revenue Cycle Redesign
  • Supply Chain

Protiviti helps healthcare organisations make the promise of digital transformation a reality. We help payers and providers alike uncover a deep understanding of the risks and opportunities presented by emerging technologies and think creatively about how these technologies can be used to improve performance and ensure interoperability. Avenues of rapid transformation are driving the need for consistent innovation throughout healthcare organisations that strive for a competitive market presence. Protiviti supports our clients in recognising and effectively responding to the need for consistent innovation through training, discovery and ideation workshops, prototyping, Customer Experience (CX) initiatives, and implementation. Healthcare Digital Services include:

  • Customer Care and Service Automation
  • Customer and Digital Transformation Strategy
  • Customer Experience
  • Innovation
  • Creative and Design
  • Content
  • Sales and Marketing Acceleration
  • Digital Experience Platforms

Our multidisciplinary team comprises attorneys, CPAs, CFEs/CFFs, data privacy professionals, and technology specialists who work with global healthcare organisations to maximise efficiencies while minimising legal risk in the face of growing healthcare litigation exposure and regulatory inquiries.Offerings include:

  • Fraud, Investigations, and Disputes
  • Digital Forensics and eDiscovery
  • Legal compliance
  • Legal department resilience and optimisation
  • Contracts management, remediation, drafting and redlining
  • Legal privacy and risk
  • Litigation readiness

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