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Medical Professional CCM Exam Syllabus Topics:
| Section | Weight | Objectives |
|---|---|---|
| Healthcare Delivery Systems and Community Resources | 10% | - Continuum of care settings - Interdisciplinary collaboration - Healthcare policy and systems - Community-based services and resources |
| Ethics, Legal, and Practice Standards | 18% | - Professional ethics and conduct - Confidentiality and privacy - Legal and regulatory requirements - Advocacy and patient rights - Scope of practice and roles |
| Quality and Outcomes Evaluation and Measurements | 10% | - Accreditation and regulatory standards - Data collection and reporting - Outcome measurement and analysis - Performance improvement - Cost-benefit and effectiveness analysis |
| Care Management | 30% | - Care coordination and collaboration - Evidence-based case management models and tools - Medication management - Caseload assignment and selection criteria - Cost containment principles - Age-specific care application - Client-centered care plan development |
| Psychosocial Concepts and Support Systems | 20% | - Abuse and neglect recognition - Behavioral change theories and models - Family dynamics and support systems - Mental health and substance use considerations - Cultural competence and diversity |
| Reimbursement Methods | 12% | - Payment and reimbursement methodologies - Insurance principles and benefit structures - Financial resources and negotiation - Managed care and accountable care concepts - Coding and utilization review principles |
Medical Professional Certified Case Manager Certification Exam (CCM) Sample Questions:
1. (Which of the following two statements are correct regarding subcontractors under FIDIC Red, Yellow, and Silver Books (edition 2017)?
Choose all of the correct answers (multiple possibilities).)
A) The Contractor shall obtain the Engineer's and the Employer's prior consent to all Subcontractors.
B) The Contract Data may identify parts of the Works which the Contractor is not entitled to subcontract.
C) If no maximum allowable accumulated value of work subcontracted is stated in the Contract Data, the Contractor shall not be entitled to subcontract the whole of the Works without prior consent of the Engineer.
D) The Contractor shall not be responsible for the acts or defaults of any Subcontractor.
2. Which two statements reflect an INCORRECT application of a Golden Principle?
A) Any deletions of General Conditions (GC) must be replaced with Particular Conditions (PC) that cover the same scope, and do not leave any roles, duties, obligations, rights, and risk allocation undefined.
B) When applying the FIDIC Red Book or Yellow Book, the Commencement Date shall be within 60 days after the Contractor receives the Letter of Acceptance, in lieu of 42 days.
C) Deleting all the clauses in the General Conditions that refer to the DAAB/DAB.
D) The Contractor ' s right to suspend work (or reduce the rate of work) effective after giving not less than
3 months (in lieu of 21 days) notice to the Employer.
3. (Sub-Clause 12.3(a) of FIDIC Red Book (edition 1999) specifies four criteria which are applicable without reference to Clause 13. A new rate shall only be appropriate if all four criteria are satisfied. Is this statement true or false?)
A) True
B) False
4. FIDIC Red, Yellow, and Silver Books (both editions) contain a provision for the Engineer or Employer to instruct the Contractor to employ a subcontractor, thereby also permitting the Contractor to refuse to employ such proposed subcontractor on the basis of a reasonable objection by a notice. Is this statement true or false?
A) True
B) False
5. (If a Section or Part has been taken-over but the Taking-Over Certificate has not been issued for the Works, the Engineer has the right to instruct a Variation to that Section/Part. Is this statement true or false?)
A) True
B) False
Solutions:
| Question # 1 Answer: B,C | Question # 2 Answer: B,C | Question # 3 Answer: B | Question # 4 Answer: A | Question # 5 Answer: B |


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