Health Plan Finance and Risks

Course Overview

As the nationwide conversation about health care affordability continues to grow, it’s more essential than ever to have a solid understanding of our industry’s financial structure and how to sustainably manage risk. The newly updated Health Plan Finance and Risk Management (AHM520) online course includes more of what you need to know right now to do your job even better.

Learning Objectives

On completion of this course, you will be able to:-

  • Analyze the role of strategic financial planning in setting a health insurance provider’s future direction
  • Gain an understanding of risk, decisions regarding risk assumption, and how health insurance providers control risk
  • Compare the difference between stop-loss insurance and stop-loss reinsurance from the perspective of health insurance providers
  • Learn about the financial risks for health insurance provider organizations that provide health care services to Medicare and/or Medicaid populations compared to risks within the commercial population
  • Distinguish between fully funded and self-funded plans and the increasing role of self-funding in the marketplace
  • Discover how to identify claim related components of health insurance providers’ financial statements
  • Recognize different reserving methodologies used by health insurance providers

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