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Medical Professional CCM Exam Syllabus Topics:
| Section | Weight | Objectives |
|---|---|---|
| Reimbursement Methods | 12% | - Payment and reimbursement methodologies - Insurance principles and benefit structures - Coding and utilization review principles - Financial resources and negotiation - Managed care and accountable care concepts |
| Healthcare Delivery Systems and Community Resources | 10% | - Interdisciplinary collaboration - Healthcare policy and systems - Community-based services and resources - Continuum of care settings |
| Care Management | 30% | - Care coordination and collaboration - Evidence-based case management models and tools - Age-specific care application - Cost containment principles - Caseload assignment and selection criteria - Client-centered care plan development - Medication management |
| Ethics, Legal, and Practice Standards | 18% | - Professional ethics and conduct - Legal and regulatory requirements - Scope of practice and roles - Confidentiality and privacy - Advocacy and patient rights |
| Psychosocial Concepts and Support Systems | 20% | - Family dynamics and support systems - Mental health and substance use considerations - Behavioral change theories and models - Abuse and neglect recognition - Cultural competence and diversity |
| Quality and Outcomes Evaluation and Measurements | 10% | - Outcome measurement and analysis - Data collection and reporting - Cost-benefit and effectiveness analysis - Performance improvement - Accreditation and regulatory standards |
Medical Professional Certified Case Manager Certification Exam (CCM) Sample Questions:
Question 1
(Under the FIDIC Red Book, which of the following statements are correct? [2017 Edition] (2 correct answers apply) Choose all of the correct answers (multiple possibilities).)
A. A decision by a DAAB is not final and binding on the Parties until it is confirmed by an arbitration award.
B. A DAAB member nominated by one of the Parties must be agreed by the other Party.
C. If the Employer or the Contractor fails to notify its dissatisfaction with an Engineer ' s ruling within the specified time, the DAAB ' s decision is final and binding.
D. An attempt to reach an amicable settlement is a mandatory requirement before an Engineer ' s ruling can be referred to a DAAB.
E. The FIDIC Red Book ' s General Conditions specify a standing DAAB.
Question 2
(Which two FIDIC Books (edition 2017) should especially be considered for use if the Employer needs the Contractor to take responsibility for the design and execution of the project. The construction will involve substantial work underground or work in other areas which tenderers cannot inspect.
Choose all of the correct answers (multiple possibilities).)
A. Red Book
B. Yellow Book
C. Silver Book by amending Sub-Clause 4.12 in the Particular Conditions
D. Silver Book without amending Sub-Clause 4.12 in the Particular Conditions
Question 3
(FIDIC Red Book (edition 2017) stipulates that the measurement shall be made as per the actual quantities executed at Site. Which one of the following statements is correct?)
A. The measurement shall be always made of the net actual quantity of each item of the Permanent Works.
B. The measurement shall be made of actual quantity of each item of the Permanent Works with allowance of shrinkage of the used materials.
C. Measurements of the actual quantity of an item of the Permanent Works that was not specified in the Bill of Quantities, the Contractor will choose the appropriate price.
D. None of the above are correct.
Question 4
(Which two of the following statements are correct regarding the first step of an Employer ' s Claim, considering that the Employer is entitled to a reduction in the Contract Price and/or an extension of the Defects Notification Period under any Clause of the Conditions of Contracts or otherwise in connection with the Contract, under the FIDIC Red, Yellow, and Silver Books (edition 2017)?
Choose all of the correct answers (multiple possibilities).)
A. The Employer shall give a Notice to the Engineer, describing the event or circumstance giving rise to the cost, loss, delay or extension of the Defects Notification Period for which the Claim is made.
B. The Notice given by the Employer must also include the legal or contractual basis of the claim, including the clause of the Contract under which it is made.
C. The Notice shall be given to the Engineer, as soon as practicable, and no later than 28 days after the claiming Party became aware, or should have become aware, of the event or circumstance.
D. A Notice from the Employer is not required in order to give a Notice to the Engineer for services requested by the Contractor.
Question 5
Which of the following documents form part of a FIDIC Construction Contract [ " Red Book " (1999)], hence, to be drafted and included among the Tender Documents? (2 correct answers apply) Choose all of the correct answers (multiple possibilities).
A. Employer ' s Requirements
B. Bill of Quantities
C. Schedule of Baselines
D. Schedule of Guarantees
E. Specifications
Solutions:
| Question 1 Answer: B,E | Question 2 Answer: B,C | Question 3 Answer: A | Question 4 Answer: A,C | Question 5 Answer: B,E |


