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• Essential elements of a contractual relationship between health plans and providers
• How health plans ensure their provider networks remain adequate to meet member needs
• The process for network provider selection
• How health plans select, contract with, and compensate specialists and healthcare facilities
• Scope and organization of the network management function in health plans
• Special requirements that affect network management for Medicare, Medicaid, and workers' compensation networks
• The primary responsibilities and obligations of health plans and providers under a provider contract
• Network strategies for access, quality, and cost-effectiveness

Reference: https://www.ahip.org/courses/network-management-ahm530

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AHIP AHM-530 Exam Syllabus Topics: