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AHIP AHM-540 Exam With Confidence Using Practice Dumps

Exam Code:
AHM-540
Exam Name:
Medical Management
Certification:
Vendor:
Questions:
163
Last Updated:
Nov 21, 2024
Exam Status:
Stable
AHIP AHM-540

AHM-540: AHIP Certification Exam 2024 Study Guide Pdf and Test Engine

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Medical Management Questions and Answers

Question 1

As a follow-up to a performance improvement plan for member services, the Stellar Health Plan conducted an evaluation of the success of the plan. Stellar conducted its evaluation as the plan was being carried out. The evaluation focused on specific activities and assessed the relative importance of those activities to the plan as a whole. This information indicates that Stellar’s evaluation of the plan was both

Options:

A.

concurrent and formative

B.

concurrent and summative

C.

retrospective and formative

D.

retrospective and summative

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Question 2

With respect to the activities of MCO medical directors, it is correct to say that medical directors typically perform all of the following activities EXCEPT

Options:

A.

maintaining clinical practices

B.

delivering performance feedback to providers

C.

participating in utilization management (UM) activities

D.

educating other MCO staff about new clinical developments or provider innovations that might impact clinical practice management

Question 3

In most health plans, the formulary system is developed and managed by a P&T committee. The P&T committee is responsible for

Options:

A.

evaluating and selecting drugs for inclusion in the formulary

B.

overseeing the manufacture, distribution, and marketing of prescription drugs

C.

certifying the medical necessity of expensive, potentially toxic, or nonformulary drugs

D.

all of the above