Healthcare Management Consulting Services

At Protiviti, we know healthcare. Our global reach continues to expand at a rapid pace as we serve leading healthcare organizations 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 organization’s chief concern is payment reform, regulatory compliance, revenue growth, cost management, cybersecurity or digital transformation, Protiviti is here for you.

Challenges and Opportunities facing the Healthcare Industry

Healthcare organizations 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.

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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 stands at the forefront of the healthcare industry by bringing our in-depth industry knowledge and skills to help provider organizations manage risks, improve operations and preserve revenue by leveraging our expertise, analytics and accelerators. Our wide range of offerings include harnessing AI, driving clinical excellence, designing and implementing digital and advanced analytics strategies, and modernizing enterprise applications. We leverage cutting-edge IT security measures, foster innovation, manage mergers & acquisitions, ensure revenue integrity, and address risk & compliance diligently.

Healthcare Payers

Protiviti helps health plans, PBMs, TPAs, state Medicaid agencies, employers, and FEHB carriers operationalize and execute solutions to enhance business performance and drive sustainable growth. Whether we are assisting with strategic planning, design initiatives, or process improvement, we apply innovation, collaboration, and technology acumen across your organization.

Healthcare Life Sciences

The life sciences industry comprises companies operating in the research, development and manufacturing of pharmaceuticals, biotechnology-based food and medicines, medical devices, biomedical technologies, nutraceuticals, cosmeceuticals, food processing, and other products that improve the lives of organisms. Protiviti supports life science clients at all stages of their evolutionary lifecycle and for the products / services they develop and bring to market. Whatever the challenge, our combination of industry, technical, security, and regulatory experts provide the necessary insights and guidance to enhance enterprise value.

Our services for Healthcare Organizations:

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

Healthcare Internal Audit and Financial Advisory

Protiviti’s world-class internal audit (IA) services provide effective insight and confidence to leaders that their organizations 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 organizations 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

Healthcare Risk & Compliance

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 Organizations
Interim Compliance Officer / Supplemental Staffing

Healthcare Technology Consulting

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 Advisory

Healthcare Business Performance Improvement

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

Healthcare Digital Innovation

Protiviti helps healthcare organizations 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 organizations that strive for a competitive market presence. Protiviti supports our clients in recognizing 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

Healthcare Legal Consulting

Our multidisciplinary team comprises attorneys, CPAs, CFEs/CFFs, data privacy professionals, and technology specialists who work with global healthcare organizations to maximize efficiencies while minimizing 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 optimization
Contracts management, remediation, drafting and redlining
Legal privacy and risk
Litigation readiness

Featured insights

FLASH REPORT

Trump 2.0: The First 100 Days – A Look at Industry Winners and Losers

When Donald Trump took office on January 20 as the 47th President of the United States, U.S. chief executive officers (CEOs) were looking forward to 2025 with renewed optimism based on the expectation that business conditions would improve. ...

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Internal Audit Benchmarking Trends in Healthcare

Global Internal Audit Standards require that a charter specify the internal audit function’s organizational position and reporting relationships and describe administrative reporting responsibilities, such as the process for approving human resources...

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AI in Healthcare: Navigating the Future with Governance and Innovation

The role of artificial intelligence (AI), which includes both machine learning (ML) and generative AI (GenAI), is becoming increasingly prominent in the business world. AI is challenging traditional models of business operations with its potential to...

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Top Compliance Priorities for U.S. Healthcare Organizations in 2025

Protiviti’s risk and compliance experts weigh in on the top compliance priorities for healthcare organizations in 2025 and what these changes mean under a new administration.Providers, payers, and life sciences organizations must refine their...

INFOGRAPHIC

Infographic | Navigating critical healthcare areas through internal audit

Coming off several years of a pandemic and the associated public health emergency, the healthcare industry continues to face complex and unpredictable risks that could have long-lasting impacts across several critical areas. Healthcare internal...

BLOG

Long-Awaited HIPAA Security Rule Revamp Formally Proposed with Significant Changes

The U.S. Department of Health and Human Services (HHS) published a Notice of Proposed Rule Making (NPRM) related to the HIPAA Security Rule, which went live on January 6, 2025, followed by a 60-day open comment period. The potential changes are the...

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EvergreenHealth’s Journey to a Comprehensive Employment Brand and Talent Marketing Strategy

EvergreenHealth's comprehensive employment brand and talent marketing strategy by Protiviti increased application rates, reduced turnover by 3.5%, and decreased recruitment expenses....

A Healthcare Giant's Journey to Evaluate Risk, Strengthen Data Use Licensing Agreements with Third-Party Vendors

Organisations should regularly monitor obligations and compliance within their third-party contract universe.

Global Health Services Company Modernizes Data and Applications with Microsoft

A global health services company needed to execute on its corporate promise to deliver affordability and convenience to its patients. However, the company discovered that there was a disconnect between that promise and intended delivery. Further...

Cloud-based Healthcare Analytics Company Expands Solutions and Customers

d2i is a cloud-based healthcare analytics solutions firm that’s on the move leveraging AWS. The company provides an unparalleled data analytics application that aggregates, harmonizes and enriches diverse data sources to some of the largest hospital...

Healthcare's The Pulse

Explore the latest edition of Protiviti's healthcare newsletter, The Pulse, where we share a roundup of our most recently released thought leadership, past and upcoming events, key industry news, and much more.

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