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Medical Professional CCM Exam Syllabus Topics:

SectionWeightObjectives
Topic 1: Healthcare Delivery Systems and Community Resources10%- Interdisciplinary collaboration
- Community-based services and resources
- Healthcare policy and systems
- Continuum of care settings
Topic 2: Quality and Outcomes Evaluation and Measurements10%- Outcome measurement and analysis
- Performance improvement
- Cost-benefit and effectiveness analysis
- Accreditation and regulatory standards
- Data collection and reporting
Topic 3: Psychosocial Concepts and Support Systems20%- Mental health and substance use considerations
- Abuse and neglect recognition
- Family dynamics and support systems
- Behavioral change theories and models
- Cultural competence and diversity
Topic 4: Reimbursement Methods12%- Insurance principles and benefit structures
- Coding and utilization review principles
- Payment and reimbursement methodologies
- Financial resources and negotiation
- Managed care and accountable care concepts
Topic 5: Ethics, Legal, and Practice Standards18%- Legal and regulatory requirements
- Professional ethics and conduct
- Confidentiality and privacy
- Advocacy and patient rights
- Scope of practice and roles
Topic 6: Care Management30%- Client-centered care plan development
- Age-specific care application
- Medication management
- Cost containment principles
- Care coordination and collaboration
- Caseload assignment and selection criteria
- Evidence-based case management models and tools

Medical Professional Certified Case Manager Certification Exam (CCM) Sample Questions:

1. (For specific probable future events or circumstances which may adversely affect the Works, FIDIC Red and Yellow Books (edition 1999) provide a duty to notify specific parties. Which two statements are correct?
Choose all of the correct answers (multiple possibilities).)

A) The Notice shall be given when the Time for Completion will be affected.
B) The Engineer has no obligation under General Conditions to notify the Contractor of such events.
C) Each Party shall advise the other and the Engineer of such events or circumstances, and the Engineer shall advise the Parties.
D) The obligation to issue such Notice requires the Contractor to give such Notice to the Engineer.


2. You are the Contract Manager for the Engineer in a hospital project using FIDIC Yellow Book (edition 2017).
The Employer demands perfection in the project ' s design and construction quality. There are many Variations initiated by the Employer during design and construction. Which one of the following is considered to be a valid Variation?

A) The Contractor submits a Value Engineering proposal regarding the lighting system for the operation rooms. The Engineer is positive about the proposal and tells the Contractor they need to look into it.
B) The Engineer requests a proposal regarding a change in type of windows and doors. The Contractor submitted the proposal accordingly to the Engineer. The Engineer instructs the Variation.
C) The Employer verbally instructs a change in the type of doors. The Engineer issued a Notice describing the required change and denying any costs for the Contractor.
D) The Engineer instructs a change in slopes of the access road to the intensive care unit to meet the Employer ' s Requirement. The Engineer does so with a Notice in accordance with Sub-Clause 3.5.


3. (Which one of the following statements regarding FIDIC Golden Principles is correct?)

A) The Particular Conditions must not change the balance of risk/reward allocation provided in the General Conditions.
B) The Particular Conditions can be changed under the condition that the balance of risk/reward allocation provided in the General Conditions provides for significantly less risk to the Contractor.
C) The FIDIC Golden Principles only apply to handling the General Conditions of a contract and should not be taken into account when preparing the Particular Conditions.
D) The Particular Conditions do not have to be drafted clearly and unambiguously, as long as the Employer understands the meaning of the risk allocation.


4. Applying FIDIC Silver Book (edition 1999), which one of the following elements shall not form part of the time Programme/revised programme?

A) The remedial work (if any) instructed under Sub-Clause 7.6.
B) The sequence and timing of inspections and tests.
C) Review periods under Sub-Clause 5.2.
D) The intended order of the works.


5. Which two of the following statements are correct regarding the dayworks under FIDIC Red, Yellow, and Silver Books (both editions)?
Choose all of the correct answers (multiple possibilities).

A) If a Daywork Schedule is not included in the Contract, the Sub-Clause related to dayworks shall not apply.
B) The dayworks related Sub-Clause is only used for remeasurement in the FIDIC Red Book (both editions) only.
C) The dayworks related Sub-Clause is also applicable to other types of works.
D) The Engineer (or the Employer in case of FIDIC Silver Book) may instruct that " a Variation shall " be executed on a daywork basis.


Solutions:

Question # 1
Answer: C,D
Question # 2
Answer: D
Question # 3
Answer: A
Question # 4
Answer: A
Question # 5
Answer: C,D

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