Health Plan Finance and Risk Management (AHM520)

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

What You’ll Learn

  • 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

Who Should Take This Course

  • Actuaries
  • Agents and brokers
  • Case managers
  • Claims managers
  • Financial planners
  • Health insurance provider staff
  • Medical directors
  • Medical management staff
  • Risk managers

Module 1: Introduction to Health Plan Finance and Risks

Module 2: Stop-Loss and Reinsurance

Module 3: Managerial Accounting

Module 4: Financial Statements

Module 5: Cost Accounting

Module 6: Performance Measures

Module 7: Financial Statement Analysis

Module 8: Strategic Planning

Module 9: Long-Term Performance Measures

Module 10: Capital Budgeting and Financial Planning

Module 11: Risk Management

Module 12: Risk Management Framework and Risk Control Processes

Module 13: Risk and Capital Management

Module 14: Medicare and Medicaid

Module 15: Health Plan Funding Methods for Employer Plans

Module 16: Reserving for Health Plans

Module 17: The Relationship Between Rating and Underwriting

Module 18: Pricing and Rate Setting for Health Plans

Module 19: Underwriting

Price: $425

This Course includes:

   Text-based content

   6 Weeks