March 24, 2020

Regional Healthcare Leader Enhances Financial Risk Management With Comprehensive Policy Review, Governance Assessment, and Training


When a routine annual audit uncovered some gaps in governance policies at a regional life sciences and healthcare nonprofit, the organization sought to go beyond standard financial controls toward greater levels of enterprise risk management.

While the organization had a strong track record of financial responsibility, they wanted to take the next step and ensure they were on track with managing enterprise risk according to contemporary industry practices. Additionally, they wanted to analyze and monitor the day-to-day implementation and effectiveness of policies.


Clark Nuber presented a range of options to the client from basic to comprehensive. Seeking to continue its heritage as a trusted regional leader, the organization chose to go with an extensive and in-depth program of risk assessment, analysis, improvement, training and monitoring.

The engagement included a full range of services across three key areas:

  1. Producing accurate and timely internal and external financial statements
  2. Implementing accounting practices that are consistently maintained and followed throughout the organization
  3. Aligning technology to support people and processes

The first two items were completed first, with the technology component to be undertaken at a later date.

The Process

We began with in-depth interviews of key leaders and personnel to obtain a broad understanding of the organization’s processes and risks. The interviews included top management and employees across functional areas such as finance and accounting, hospital and physician billing, people and materials management, IT teams, compliance and risk management, and end users of financial statements and reporting. These interviews provided a baseline understanding of the risks, process inefficiencies, internal control, gaps, and areas of strength.

After this initial phase, we then assessed existing practices and documentation to develop corrective action plans to address deficiencies. We created heat maps to show areas of greatest risk and assist with prioritization. We also documented procedures that previously existed only as organizational knowledge so that they could be used consistently, even after employee turnover.

To address the gaps and inefficiencies uncovered during this analysis, we created new policies and procedures and provided guidance on healthcare industry best practices. We worked closely with financial department leadership to onboard managers and staff to new practices. Furthermore, we oversaw the implementation of these plans, providing audit preparation support, feedback, training, and ongoing monitoring to ensure desired improvements were being made.


By combining the in-depth analysis of the client’s day-to-day risk management and financial reporting activities with our team’s extensive knowledge of healthcare industry best practices, we were able to provide targeted and actionable recommendations. Then, through active monitoring, training, and support, we helped their staff operationalize these recommendations to ensure they were fully understood and deployed in the most effective manner.

As a result of this engagement, the client has achieved:

  • Enhanced accuracy of financial statements
  • A clean audit with no management letter recommendations
  • Greater ability to prevent and detect fraudulent activity
  • Better data collection and organization to simplify future audits
  • Role clarity and accountability
  • Strengthened data integrity leading to improved cash management
  • In-depth understanding among staff not only of the updated procedures, but the reasons behind them
  • Staff development and increased morale
  • End-to-end organizational alignment on risk management goals, policies, and key performance indicators

Today, the organization can enjoy increased confidence in its financial reporting and risk management capabilities, helping it continue to grow its status as one of the most well-known and respected healthcare organizations in the region.

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