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Who should take the AHM-540 exam

Financial executives working with clients looking to maximize their health dollars
Case administrators and medical directors who inquire a broader administrative background
Medical management employees working in hospitals, health systems, and, health insurance plans
Agents and brokers who expert in life and health insurance
Teachers at the school level who teach health care administration
Employees who work for health care providers or health insurance plans and want to get the educational background to proceed with a management position in the industry

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Reference: https://www.ahip.org/courses/medical-management-ahm540

How to book the AHM-540 Exam

These are following steps for registering the AHM-540 exam. Step 1: Visit to AHIP Exam Registration Step 2: Signup/Login to AHIP INSURANCE EDUCATION account Step 3: Search for AHM-540 Exam Certifications Exam Step 4: Select Date, time and confirm with payment method

AHIP AHM-540 Exam Syllabus Topics:

Section	Objectives
Clinical Practice and Quality Management	- Clinical practice management 1. Medical policies and practice parameters 2. Evidence-based clinical guidelines - Quality management 1. Performance measurement 2. Quality assessment 3. Quality improvement methodologies
The Medical Management Function	- Relationship of medical management to other health plan functions 1. Sales and marketing 2. Risk management 3. Network management 4. Information management and technology 5. Claims administration 6. Finance 7. Legal affairs - Role of medical management 1. Delegation and subdelegation of medical management functions 2. Goals and components of medical management programs 3. Medical management committees 4. Responsibilities of the medical director - Environmental influences on medical management 1. Purchaser, provider, and member expectations 2. Federal and state regulatory requirements 3. Impact of environmental factors on delegation 4. Accreditation organizations and standards
Medical Management Across Care Settings	- Medical management for acute care 1. Post-acute care management 2. Acute care strategies - Medical management for government-sponsored programs 1. Other government-sponsored programs 2. Medicaid 3. Medicare - Medical management for pharmacy services 1. Pharmacy benefit management 2. Specialty services management
Preventive and Care Management Programs	- Utilization management 1. Authorization and utilization review processes 2. Medical necessity review - Preventive care and self-care programs 1. Member education and wellness 2. Health promotion initiatives - Case management 1. Management of complex cases 2. Care coordination - Disease management 1. Chronic disease programs 2. Population health management