Network Management

Here you have the best AHIP AHM-530 practice exam questions

You have 202 total questions across 41 pages (5 per page)
These questions were last updated on February 15, 2026
This site is not affiliated with or endorsed by AHIP.

Question 1 of 202

By definition, a measure of the extent to which a health plan member can obtain necessary medical services in a timely manner is known as:

Network management

Quality

Cost-effectiveness

Accessibility

Question 2 of 202

Decide whether the following statement is true or false:
The organizational structure of a health plan's network management function often depends on the size and geographic scope of the health plan. With respect to the size of a health plan, it is correct to say that smaller health plans typically have less integration and more specialization of roles than do larger health plans.

True

False

Question 3 of 202

The following paragraph contains an incomplete statement. Select the answer choice containing the term that correctly completes the statement.
One important activity within the scope of network management is ensuring the quality of the health plan's provider networks. A primary purpose of __________________ is to review the clinical competence of a provider in order to determine whether the provider meets the health plan's pre-established criteria for participation in the network.

authorization

provider relations

credentialing

utilization management

Question 4 of 202

One important aspect of network management is profiling, or provider profiling. Profiling is most often used to:

measure the overall performance of providers who are already participants in the network

assess a provider's overall satisfaction with a plan's service protocols and other operational areas

verify a prospective provider's professional licenses, certifications, and training

familiarize a provider with a plan's procedures for authorizations and referrals

Question 5 of 202

Network managers rely on a health plan's claims administration department for much of the information needed to manage the performance of providers who are not under a capitation arrangement. Examining claims submitted to a health plan's claims administration department enables the health plan to:

determine the number of healthcare services delivered to plan members

monitor the types of services provided by the health plan's entire provider network

evaluate providers' practice patterns and compliance with the health plan's procedures for the delivery of care

all of the above

About the AHIP AHM-530 Certification Exam

About the Exam

The AHIP AHM-530 (Network Management) validates your knowledge and skills. Passing demonstrates proficiency and can boost your career prospects in the field.

How to Prepare

Work through all 202 practice questions across 41 pages. Focus on understanding the reasoning behind each answer rather than memorizing responses to be ready for any variation on the real exam.

Why Practice Exams?

Practice exams help you familiarize yourself with the question format, manage your time, and reduce anxiety on the test day. Our AHM-530 questions are regularly updated to reflect the latest exam objectives.