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• Scope and organization of the network management function in health plans
• Essential elements of a contractual relationship between health plans and providers
• Special requirements that affect network management for Medicare, Medicaid, and workers' compensation networks
• Network strategies for access, quality, and cost-effectiveness
• The primary responsibilities and obligations of health plans and providers under a provider contract
• The process for network provider selection
• How health plans ensure their provider networks remain adequate to meet member needs
• How health plans select, contract with, and compensate specialists and healthcare facilities

Network Management AHM-530 Exam

Network Management AHM-530 Exam is designed by the Academy of Health Care Administration (AHM) and sponsored by the US Health Insurance Plans and the Blue Cross Blue Shield Association. AHM is a self-study examination based program. AHM-530 Exam validates candidate has knowledge about the network management function in health insurance plans. This exam also verifies the candidate has a strong understanding of network development strategies such as risk management, recruiting, selection and contracting and network maintenance strategies such as managing provider performance and feedback.

Reference: https://www.ahip.org/courses/network-management-ahm530

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AHIP AHM-530 Exam Syllabus Topics: