Network Management

Course Overview

Organizations that make network management a priority are better positioned to provide high quality, value-focused care, while maintaining financial sustainability. The Network Management (AHM530) online course is a deep dive into how health insurance providers leverage the network management function to seamlessly integrate health care providers, clinics, hospitals, pharmacies, and other essential stakeholders

What You’ll Learn
  • Gain a detailed understanding of the scope and organization of the network management function within health insurance provider organizations
  • Understand how network strategies improve access, quality, and cost-effectiveness
  • Learn the process for network provider selection
  • Master the essential elements of a contractual relationship between health insurance providers and health care providers
  • Identify the primary responsibilities and obligations of health insurance providers and health care providers under a provider contract
  • Map out how health insurance providers select, contract with, and compensate specialists and health care facilities
  • Recognize special requirements that affect network management for Medicare, Medicaid, and workers’ compensation networks
  • Explore how health insurance providers ensure their provider networks remain adequate to meet member needs
Who Should Take This Course
  • Agents and brokers
  • Case managers
  • Financial planners
  • Health insurance provider staff
  • Medical directors
  • Medical management staff

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