When Rock Rapids-native Sandra Dieren graduated from Buena Vista University with an accounting degree, she started down the ideal career path. She was hired by KPMG, one of the world’s biggest public accounting firms. During her five years with KPMG, she focused on the health-care field, auditing health-care providers and hospitals across the state. Dieren says public accounting is a stressful profession, with long hours and a lot of travel. Eventually, she decided to leave KPMG.

“I think I lasted longer there than most,” Dieren said. Of the 12 accountants who entered the firm when she did, only two others were still there when she left. Nonetheless, Dieren says it was her experience as a public accountant for KPMG that opened doors for her at Iowa Health Physicians, a subsidiary of Iowa Health System.

There she served as a financial analyst for two and one-half years. She liked the lower stress level of her new job. Then an opportunity arose to become the director of finance for Iowa Health System’s InTrust Home Care, which provides home health-care services, including shots, hydration and chemotherapy, hospice services, and home medical equipment. She currently serves the company as chief financial officer and vice president.

“It’s been a great learning experience, and more challenging than I expected,” Dieren said.

Instead of just reacting to a company’s finances, she gets to work with InTrust’s senior managers to make strategies for the company’s future. Dieren says it’s a unique opportunity, and InTrust is always looking for new fields to enter and new ways to grow.

The company faces shrinking reimbursement dollars and rates set by Medicare and often provides services at a loss, so its leaders are challenged to provide quality care as efficiently as possible.

Dieren says the face of health care will change dramatically over the next 10 years.

“With the aging Iowa population, home care should and will become a more prevalent provider,” she said. “It’s more cost-effective than an inpatient setting. It’s an exciting time to be in the industry.”