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AHM-530 Exam topics
Candidates must know the exam topics before they start of preparation. Because it will really help them in hitting the core. Our AHM-530 exam dumps will include the following topics:
- The primary responsibilities and obligations of health plans and providers under a provider contract
- Special requirements that affect network management for Medicare, Medicaid, and workers' compensation networks
- Scope and organization of the network management function in health plans
- How health plans select, contract with, and compensate specialists and healthcare facilities
- Essential elements of a contractual relationship between health plans and providers
- The process for network provider selection
- How health plans ensure their provider networks remain adequate to meet member needs
- Network strategies for access, quality, and cost-effectiveness
Reference: https://www.ahip.org/courses/network-management-ahm530
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Certification Path
The Network Management AHM-530 Exam certification path includes only one AHM-530 certification exam.
AHIP AHM-530 Exam Syllabus Topics:
| Section | Objectives |
|---|---|
| Network Performance and Compliance | - Network performance metrics - Regulatory and accreditation requirements |
| Utilization and Care Management | - Referral and authorization systems - Utilization management tools and techniques |
| Provider Credentialing and Oversight | - Credentialing and re-credentialing processes - Quality monitoring and performance evaluation |
| Provider Contracting and Reimbursement | - Value-based reimbursement models - Contract negotiation and terms - Fee-for-service, capitation, and bundled payments |
| Network Structure and Design | - Types of provider networks (HMO, PPO, POS) - Network adequacy and geographic coverage requirements - Network configuration strategies |
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