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Medical Professional CCM Exam Syllabus Topics:

SectionWeightObjectives
Care Delivery and Reimbursement Methods31%- Case management concepts, processes, and principles
- Reimbursement pathways and utilization management tools
  • 1. Managed care models and funding sources
  • 2. Government and commercial insurance plans
Ethical, Legal, and Practice Standards15%- CCMC Code of Professional Conduct parameters
- Regulatory compliance requirements and frameworks
  • 1. Patient privacy mandates and HIPAA
  • 2. Affordable Care Act impacts
Rehabilitation Concepts and Strategies9%- Worker recovery and return-to-work solutions
- Vocational and physical rehabilitation pathways
  • 1. Chronic illness and disability support models
  • 2. Assistive device adaptation strategies
Psychosocial Concepts and Support Systems27%- Behavioral health conditions and dependencies
- Client dynamics and social determinants of health
  • 1. Cultural competency and spiritual influences
  • 2. Family and support system evaluation
  • 3. Crisis intervention techniques
Quality and Outcomes Evaluation and Measurements18%- Quality indicator metrics and performance tools
  • 1. Accreditation standard configurations
  • 2. Cost-benefit analysis algorithms
- Caseload calculation metrics and tracking standards

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

1. (Which one of the following statements is correct regarding the Employer ' s Representative under the FIDIC Silver Book (edition 1999)?)

A) The Employer may appoint an Employer ' s Representative to act on his behalf under the Contract but has to consult the Contractor to agree to this Representative.
B) The Employer must always appoint an Employer ' s Representative to act on his behalf under the Contract.
C) The Employer may appoint an Employer ' s Representative to act on his behalf under the Contract.
D) The Representatives of both the Employer and the Engineer have no authority to amend the Contract at all.


2. (Under FIDIC Red Book (edition 1999) a notice may be delivered to which two addresses?
Choose all of the correct answers (multiple possibilities).)

A) The address provided for by the recipient of the notice.
B) The address of the Site.
C) The address stated in the Contract Data.
D) The address of the Contractor ' s Representative.


3. Under the FIDIC Red Book, which one of the following statements is correct for a claim by the Contractor?

A) It is the Employer ' s Representative who must first respond to the claim by the Contractor.
B) If the Engineer does not make a determination, the Employer and the Contractor are unable to agree to settle an issue that gave rise to a claim.
C) The Employer has the authority to accept a claim by the Contractor, even in the case of the Contractor ' s failure to comply with the notice requirements.
D) The Engineer ' s response to a claim by the Contractor is final and binding upon the Employer.
E) The Engineer ' s response to the Contractor ' s submission of detailed particulars that are required by the procedure for claims by the Contractor must include the Engineer ' s final decision on the quantum.


4. Which one of the following is NOT considered a change made in the 2017 edition of the FIDIC Red, Yellow, and Silver Books?

A) New procedures requiring the Contractor to prepare and implement a Compliance Verification System to show that the design, materials, workmanship and certain other matters all comply.
B) The concentration on dispute avoidance, including an enhanced role for the Dispute Avoidance and Adjudication Board (DAAB) in this respect, and promoting cooperation between the parties during the project.
C) New procedures requiring the Contractor to prepare and implement a Quality Management System to show compliance with the Contract requirements.
D) A fair and balanced approach where risk is allocated to the Party that is best able to bear and control that risk.


5. If a FIDIC Red, Yellow, or Silver Book (edition 2017) is applied, in which of the following two cases is the Contractor required to submit a revised programme?
Choose all of the correct answers (multiple possibilities).

A) The Contractor shall revise the Programme only by request from the Engineer or the Employer (in case of FIDIC Silver Book).
B) To accurately reflect the actual progress of the Works, whenever any Programme ceases to reflect actual progress or is otherwise inconsistent with the Contractor ' s obligations.
C) To accurately reflect the actual progress of the Works, but only if any Programme ceases to reflect actual progress with at least 42 days.
D) Upon a request from the Engineer (under FIDIC Red or Yellow Books) or Employer (under FIDIC Silver Book) notifying it that the Programme fails to comply with the Contract, to a specified extent, or no longer reflects actual progress or is otherwise inconsistent with the Contractor ' s obligations.


Solutions:

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

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