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Medical Professional CCM Exam Syllabus Topics:
| Section | Weight | Objectives |
|---|---|---|
| Topic 1: Quality and Outcomes Evaluation and Measurements | 10% | - Performance improvement - Cost-benefit and effectiveness analysis - Data collection and reporting - Accreditation and regulatory standards - Outcome measurement and analysis |
| Topic 2: Psychosocial Concepts and Support Systems | 20% | - Family dynamics and support systems - Behavioral change theories and models - Mental health and substance use considerations - Cultural competence and diversity - Abuse and neglect recognition |
| Topic 3: Care Management | 30% | - Client-centered care plan development - Care coordination and collaboration - Evidence-based case management models and tools - Cost containment principles - Medication management - Caseload assignment and selection criteria - Age-specific care application |
| Topic 4: Healthcare Delivery Systems and Community Resources | 10% | - Community-based services and resources - Interdisciplinary collaboration - Healthcare policy and systems - Continuum of care settings |
| Topic 5: Ethics, Legal, and Practice Standards | 18% | - Professional ethics and conduct - Confidentiality and privacy - Advocacy and patient rights - Legal and regulatory requirements - Scope of practice and roles |
| Topic 6: Reimbursement Methods | 12% | - Coding and utilization review principles - Financial resources and negotiation - Payment and reimbursement methodologies - Insurance principles and benefit structures - Managed care and accountable care concepts |
Medical Professional Certified Case Manager Certification Exam (CCM) Sample Questions:
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. 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. - D. Deleting all the clauses in the General Conditions that refer to the DAAB/DAB.
Correct Answer: B,D 🗳️
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(Golden Principle 2 states that " The Particular Conditions must be drafted clearly and unambiguously. " Which statement best underlines this Golden Principle in relation to the FIDIC Red, Yellow, and Silver Books (both editions)?)
- A. In the Particular Conditions, all changes to the General Conditions must be clearly identified by reference to specific Sub-Clause numbers. Additionally, the Particular Conditions Sub-Clauses must clearly indicate the relationship between the newly introduced text and the corresponding General Conditions Sub-Clauses' original text, e.g., addition, omission, replacement, or amendment.
- B. When clarifications are given during the tender period, which might impact several general conditions, it is not necessary to amend all these conditions through the Particular Conditions or to consider which exact general conditions require amendment, as such clarifications are deemed to be self-explanatory.
- C. Modifications made to the Conditions of Contract during tender negotiations that were only documented in emails between the Parties can be part of the Contract as long as those emails are subsequently included in the List of Contract documents. In such a case, it is not necessary to incorporate those modifications in, for instance, the Particular Conditions.
- D. Clarifications to the meaning of tender documents together with answers to tenderers' inquiries made during the tender period by the Employer can be inconsistent. If Sub-Clause 1.5 does not provide for the right order, this Sub-Clause can be amended explicitly or implicitly, and this can be done through any of the documents mentioned in Sub-Clause 1.5.
Correct Answer: A 🗳️
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Which FIDIC Book (edition 2017) should be considered first by an Employer that is an experienced employer who knows exactly what they want from a design & engineering perspective?
- A. Yellow Book
- B. Red Book
- C. Yellow or Silver Book
- D. Silver Book
Correct Answer: B 🗳️
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Which two statements are correct regarding the FIDIC Red Book (edition 2017)?
- A. In some cases, if a certain information is not provided in the Contract Data, the relevant Sub-Clause shall not be applicable.
- B. Words and expressions stated in Sub-Clause 1.1 Definitions do not apply in respect of Specifications and Drawings.
- C. There is never a difference in effect whether in the Particular Conditions when the term " Works " is used, or when the term " works " is used.
- D. Contract Data contains information which is required by certain Sub-Clauses in the General Conditions.
Correct Answer: A,D 🗳️
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In which one of the following circumstances is it recommended to select the Contractor after a two-stage procurement procedure (pre-qualification + tender procedure)?
- A. When the works are simple and of short duration.
- B. If there is international financing for the project, it is always necessary to conduct a two-stage procurement procedure.
- C. In case of large scale works, where there are several companies likely to have an interest in submitting an offer.
- D. When there is a limited number of capable experienced contractors available and ready to take part in the procurement.
Correct Answer: C 🗳️
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