Transformation of Governance, Risk & Compliance Operations in Healthcare 

About the Client 

Our client is a leading healthcare benefits organization based in Chicago, serving thousands of members nationwide. They are structured as a multi-employer trust fund and provide health benefits to workers primarily in the hospitality, food service, and gaming industries. Their mission is to offer high‑quality, affordable health care with better value and service than what is typically available in the market. They emphasize innovation, compliance, and participant engagement. 
They currently serve approximately 200,000 children and adults across the United States. 

Business Challenge 

Fragmented GRC operations led to inefficiencies, rising costs, and compliance risks 

As a healthcare benefits organization operating under a trust structure, the client had to balance cost, quality, and regulatory compliance.  This included ensuring regulatory & legal compliance (HIPAA, insurance regulations, labor/trust fund regulations).  

However, the client faced several pain points in their governance, risk, and compliance (GRC) operations, which had direct business implications: 

• Manual compliance checks increased operational cost and slowed compliance readiness- Many compliance processes were handled manually (spreadsheets, emails, manual control testing), causing delays and risk of human error.  

• Lack of Audit readiness led to higher audit costs, last‑minute scrambles, and reputational risk- Evidence and control documentation were scattered or late, making audit preparedness inconsistent.  

• Limited visibility into vendor risk caused delays in onboarding providers and potential financial / operational disruptions- Vendor risk posture was not centrally visible, impacting provider networks and benefits administration.  

• Disconnected processes increased the probability of compliance failures and regulatory fines- Incidents did not feed into risk frameworks, leading to reactive rather than proactive compliance management.  

The Zuci Solution 

Transformed GRC operations through integrated ServiceNow workflows and RPA automation 

We partnered with the client to architect and implement a GRC transformation. Each component was designed not only to fix inefficiencies but also to embed resilience and forward-looking governance practices. 

ServiceNow GRC Implementation to create a single source of truth 

Deployed Policy, Risk, and Vendor Risk modules to centralize compliance, automate control testing, and standardize vendor risk assessments. This reduced duplication and enabled proactive compliance management. 

Automation via RPA to reduce manual efforts, eliminate errors and free up staff 

Used UiPath to automate repetitive compliance workflows such as evidence collection, control testing reminders, and policy tracking. 

Integration of GRC with ITSM for a centralized evidence repository 

Connected GRC modules with ITSM workflows so incidents feed into risk events; real‑time mapping between incidents and risks enabled faster remediation. This helped shift the organization from reactive firefighting to proactive incident-to-insight management.  

Embedded risk management discipline into daily operation through operationalization & training 

Defined process flows, roles, and responsibilities, plus training for staff to use dashboards and manage vendor risk cycle. This inculcated management discipline into daily operations, improving accountability and resilience.