How a major healthcare insurer is tapping external resources to address its evolving internal audit and risk assessment needs

Client’s challenge


Although this leading nonprofit healthcare organization will not be required to comply with certain provisions of the Sarbanes-Oxley Act until 2009, the company’s general auditor decided to enhance its audit and risk management practices without delay.

At the time, the company relied on a single professional services firm for both its internal and external audit needs. To separate responsibility for these functions, the existing provider agreed to continue as external auditor — assist the company in preparing to comply with the requirements of Sarbanes Oxley. This request was soon followed by others, however, as the company discovered that meeting the full scope of its evolving needs required subject matter specialists with a broad set of competencies in internal audit, compliance, and risk management, as well as technology and process skills specific to the managed care and health insurance industry.

PwC helped this company manage risk and improve stakeholder value through dedicated internal audit co-sourcing services led by an experienced, locally-based client service team. The team worked closely with management to identify project-specific risks that could lead to financial, operational, IT or reputational "surprises".

PwC also identified opportunities to enhance stakeholder value by implementing sustainable control enhancements and process improvements. In addition to its core internal audit activities, PwC also helped management document and test IT-based controls in order to enable it to provide assurance to its customers under Statement on Auditing Standards No. 70, Service Providers. The internal audit team’s close coordination with the company's registered public accounting firm and the adoption of standard communication practices ensured project consistency and greatly contributed to the success of the relationship.

As PwC deepened its understanding of the company’s operations, its culture, values, stakeholder objectives and risk management priorities, senior executives began tapping PwC resources for a variety of specialized engagements. They sought insight into enterprise-wide risk assessments and annual audit planning activities from the most senior members of the PwC team, several of whom brought direct operational experience in the industry.

The company also drew on PwC’s ability to provide it with support from specialists with knowledge in areas related to Treasury operations, actuarial pricing and underwriting analysis, purchasing and procurement optimization, ERP operations and control, project management office optimization, and disease.

With PwC's help, the company has made substantial progress towards Sarbanes-Oxley readiness well ahead of its regulatory deadline. Its co-sourced internal audit activities are well coordinated and have established a strong record in meeting the expectations of both the board and senior executives.

With PwC's assistance, the company has strengthened controls, improved process efficiency and generated cost savings. Most importantly, however, the company has succeeded in embedding an awareness of risk and controls throughout the organization and, in so doing, has improved its risk and compliance management. Based on this record of achievements, the company considers PwC a valuable resource to assist management in achieving their strategic goals.


Contacts
Dennis Bartolucci
US internal audit services leader

© 2008 PricewaterhouseCoopers. All rights reserved. PricewaterhouseCoopers refers to the network of member firms of PricewaterhouseCoopers International Limited, each of which is a separate and independent legal entity.
Accessibility information Skip navigation Countries online