Washington, D.C.

Nashville, TN


Health Plan Finance And Risk Management (AHM520)

Get a comprehensive look at health insurance plan finance. You’ll learn about financial management techniques, funding, risk management, provider reimbursement, plan risk, pricing, underwriting, and rating methods.

What You’ll Learn:

  • Key accounting principles associated with a health plan’s financial information.
  • Types of risks health plans face and approaches they use to manage them.
  • Differences between fully funded and self-funded health plans.
  • Major risks and cost factors associated with the delivery and financing of health-care services under Medicare and Medicaid contracts.
  • Key factors and methods associated with underwriting and rating healthcare benefits.
  • Factors health plans consider when developing and pricing healthcare products.
  • How to analyze and interpret results of a health plan’s financial statements through the use of financial ratios.
  • How to use financial information to develop a health plan’s strategic plan and manage the health plan’s cash and capital effectively.

Who Should take this Course:

  • Employees who work for health care providers or health insurance plans and want to acquire the educational background to pursue a management position in the industry
  • Case managers and medical directors who seek a broader administrative background
  • Educators at the college level who teach health care administration
  • Financial planners, and agents and brokers who specialize in life and health insurance
  • Medical management staff working in hospitals, health systems, HMOs, health insurance plans, and PPOs
  • Consumers and others in related fields who seek expertise in this area


$220 AHIP Members; $280 Non-members

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Earn a Designation

This course is good towards earning the following Academy for Healthcare Management designation:

Fellow, Academy for Healthcare Management (FAHM®)

Sponsored by America’s Health Insurance Plans and the Blue Cross Blue Shield Association, AHM relies on both associations’ decades of experience providing continuing education for health insurance plan professionals. AHM serves more than 1,300 health insurance plans caring for and providing coverage to more than 200 million people.