AHM Medical Management AHM-540 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-540 Exam validates candidate has knowledge about the medical policy and technology evaluation, appropriateness of care issues, authorization systems, and clinical practice guidelines. This exam also verifies the candidate has the ability to discover focused strategies for utilization management, such as clinical paths and disease management. This exam also evaluates the candidate proficiency in accreditation, quality improvement, benchmarking, performance measurement, and legal aspects of QM, as well as QM strategies for different clinical settings.
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Reference: https://www.ahip.org/courses/medical-management-ahm540
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| Section | Objectives |
|---|---|
| Topic 1: Clinical Practice and Quality Management | - Quality management
|
| Topic 2: Preventive and Care Management Programs | - Utilization management
|
| Topic 3: The Medical Management Function | - Relationship of medical management to other health plan functions
|
| Topic 4: Medical Management Across Care Settings | - Medical management for pharmacy services
|
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