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Reference: https://www.ahip.org/courses/health-plan-finance-and-risk-management-ahm520
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AHIP AHM-520 Exam Syllabus Topics:
| Section | Objectives |
|---|---|
| Topic 1: Risk Assessment and Risk Management | - Risk identification and evaluation
|
| Topic 2: Medical Loss Ratio and Compliance | - Compliance requirements
|
| Topic 3: Health Plan Financial Structures | - Revenue sources and premium development
|
| Topic 4: Claims Analysis and Utilization Management | - Utilization management
|
| Topic 5: Regulatory and Compliance Framework | - Governance and reporting
|
| Topic 6: Actuarial Principles and Forecasting | - Actuarial concepts
|
| Topic 7: Provider Payment Models | - Traditional and alternative reimbursement
|
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