HCQM - Health Care Quality & Management

The Health Care Quality & Management certification (HCQM) Certification exam is intended for all nurses, allied health workers, and other medical professionals dedicated to quality improvement, managed care, utilization management, risk management, workers' compensation and case management principles. The American Board of Quality Assurance and Utilization Review Physicians (ABQAURP) administers this exam.

Eligibility Requirements

• Current license free from restrictions in every U.S. state or territory candidate holds a license 

• Completed at least 208 hours of documented involvement in any of the following categories within the past five years:

  • Quality Improvement, Utilization Management

  • Risk Management

  • Case Management/Disease Management

  • Managed Health Care Systems

  • Transitions of Care

  • Government.

• Complete the ABQAURP Core Body of Knowledge online course OR 25 hours of approved continuing medical education (CME) in one or more of the exam categories

• Two professional references (colleagues or supervisors)

• Professional English language proficiency, if applicable

Completion Time: Candidates have 4 hours to complete the HCQM exam

Cost:

• Exam Fee ABQAURP Members: $695

• Exam Fee Non-Members: $795 

• U.S. Application Fee (non-refundable) ABQAURP Member: $160

• U.S. Application Fee (non-refundable) Non-Member: $250

• International Application Fee (non-refundable) ABQAURP Member: $260

• International Application Fee (non-refundable) Non-Member: $350

• Subspecialty certification (if desired): $200

The HCQM certification exam consists of 175 multiple-choice questions and candidates have 4 hours to complete it. Candidates receive Pass/Fail results immediately following completion of the exam. HCQM exam topics include: 

• Accreditation Organizations

• Transitions of Care (TOC)

• Credentialing and Privileging

• Pay-for-Performance & Value-Based Care

• Insurance and Managed Care

• Workers' Compensation (WC)

• Professional Role

• Quality Improvement, Management and Assurance

• Utilization Management

• Clinical Resource Management

• Case Management

• Risk Management / Patient Safety

• Regulatory Environment

Test Dates

Exam dates vary from year to year. In 2025, the exam window ran from March 1 through September 30.

Candidates may take the exam in person at internationally-located Prometric Testing Centers or take it online anytime, from anywhere through Remote Proctoring (ProProctor).

Application Process

• Log in or create an account

• Download the HCQM Exam Candidate Handbook 

• Apply for the HCQM Certification Exam online

• Click “Register Myself”

• Click “Edit registrant information”

• Enter required information

• Proceed to checkout

• Enter credit card information

• Prepare for the exam

Once certified, HCQM professionals may apply for certification in one of several subspecialties, including:

• Case Management

• Managed Care

• Patient Safety / Risk Management

• Physician Advisor

• Transitions of Care

• Workers’ Compensation

Subspecialty certification requirements include:

• 312 hours of documented work in the subspecialty

• 24 hours of continuing education in the applicable subspecialty

Alternatively, candidates may apply for subspecialty registration during initial certification.

HCQM certification is valid for two years.The initial cycle begins on January 1 of the year after passing the exam to December 31 of the second year.  During each recertification cycle, each member must:

• Complete a minimum of 8 credit hours of continuing education relevant to HCQM

• Stay current with annual dues

ABQAURP automatically sends an updated HCQM Diplomate certificate to renewing members upon satisfactory completion of recertification requirements.

Recertification requires completion of at least 8 CME/CE hours relevant to Health Care Quality and Management. Candidates may obtain these hours through ABQAURP-accredited continuing education using any combination of the following:

• Attending any ABQAURP-accredited CE Conference

• Completing any ABQAURP-accredited CE Online Course(s)

• Attending any ABQAURP-accredited jointly provided program

• Developing an approved CE course or conference presentation for ABQAURP 

Alternately, candidates may complete 8 CME/CE credit hours of HCQM-focused content through non-ABQAURP accredited CE programs. However, there’s a $150 processing and verification fee using this option. Diplomate members may also retake the exam instead of completing CME/CE credits.

• HCQM Candidate Handbook

• Online Core Body of Knowledge Course  

• Exam Preparation 

• Exam Topics

• Sample Questions

• Reading Material

Other related certifications include:

• NAHQ Certified Professional in Healthcare Quality (CPHQ)

• IHI Certified Professional in Patient Safety (CPPS)

• NCC Obstetric and Neonatal Quality and Safety (ONQS)