I have passed AHM-530 before.
These are following steps for registering the AHM-530 exam. Step 1: Visit to AHIP Exam Registration Step 2: Signup/Login to AHIP INSURANCE EDUCATION account Step 3: Search for AHM-530 Exam Certifications Exam Step 4: Select Date, time and confirm with payment method
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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
| Section | Weight | Objectives |
|---|---|---|
| Topic 1: Government Program Network Requirements | 12% | - Medicaid and workers’ compensation network standards - Medicare network adequacy rules |
| Topic 2: Specialist and Facility Network Management | 15% | - Specialist network design and contracting - Hospital, ancillary, and facility network management |
| Topic 3: Network Adequacy and Performance Monitoring | 8% | - Access, quality, and capacity metrics - Ongoing network evaluation and maintenance |
| Topic 4: Provider Contracts and Compensation | 25% | - Reimbursement models: FFS, capitation, bundled payments - Contract terms, obligations, and legal requirements |
| Topic 5: Provider Selection and Credentialing | 20% | - Credentialing and recredentialing standards - Selection criteria and processes |
| Topic 6: Scope and Organization of Network Management | 20% | - Network strategy alignment with organizational goals - Role and function within health plans |
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