Global Healthcare Industry Lead
Richard is a Managing Director in Protiviti’s Dallas office and has 16 years professional experience providing operational, financial, and regulatory consulting and internal audit services to the healthcare industry. Richard leads Protiviti’s Global Provider Practise and is also the Central Regional Healthcare Industry Lead. Prior to joining Protiviti, Richard was a Project Manager at Arthur Andersen and provided internal audit and business and technology risk consulting services to healthcare clients. Richard directs numerous internal control and process improvement engagements for provider and payer organisations, and is a frequent speaker on internal audit, compliance, and revenue improvement initiatives.
- Directed multiple internal audit functions for acute and long-term care hospital systems, surgery center ventures, hospital management companies, and health insurance plans, which included performing a variety of control and business improvement projects, including reviews of SAS70/SSAE16 procedures. Reviews included finance and accounting control assessments, enterprise risk assessments, clinical and revenue operations assessments, construction and real estate programme assessments, financial statement audits, vendor and payer contract compliance reviews, clinical trials and IRB compliance audits, accounts payable/materials management control reviews, electronic health record and patient accounting implementation/operational reviews (Epic, Cerner, Siemens, McKesson, Meditech, etc.), payroll, and various IT general control reviews.
- Directed numerous provider revenue cycle improvement and transformation initiatives across access, charge capture, billing, collections, and denials management functions. Key activities included identifying and implementing process and system improvements across multiple patient care, finance, and revenue departments and achieving significant benefits in net revenue and sustainable cash, cash collected as a percentage of revenue, and accounts receivable days reduction.
- Directed numerous regulatory compliance assessments and process improvement projects, including those related to HIPAA/HITECH, CMS Medicare Managed Care rules, Stark laws, physician contracting and property leasing, clinical coding, government reimbursement, OIG compliance agreement requirements, etc. Process improvement initiatives included standardisation, contract management, data abstraction, policies and procedures, controls, reporting, etc.
- Directed numerous projects for a large health plan and managed services organisation. Projects included planning and/or execution of a project risk management office for a large scale claims system implementation, provider connectivity strategies, and risk management for a health information exchange implementation.
- Directed finance transformation and financial controls improvement projects for health plans, including a large Medicare Advantage health plan. Processes included within scope include enrollment, contracting, claims processing, financial recovery, reserves, premium revenue, financial reporting, commissions, payments, etc.
- Directed numerous Sarbanes-Oxley 404 internal control documentation, evaluation, and testing programmes. Projects included performing entity level risk assessments, prioritising financial statement elements and key processes, and performing detailed analyses of key financial reporting and operational processes. Analyses also included IT assessments of key applications.
- Master in Business Administration in Accounting and Information Systems
- Bachelor of Arts, Accounting
Professional Memberships & Certifications
- Project Management Professional (PMP)
- Accreditation in Quality Assessment and Validation
- Health Care Compliance Association (HCCA)
- Healthcare Financial Management Association (HFMA)
- Association of Healthcare Internal Auditors (AHIA)
- America’s Health Insurance Plans (AHIP)
- Project Management Institute (PMI)
- Institute of Internal Auditors (IIA)