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Medical Professional CCM Exam Syllabus Topics:
| Section | Weight | Objectives |
| Topic 1: Quality and Outcomes Evaluation and Measurements | 10% | - Cost-benefit and effectiveness analysis
- Performance improvement
- Outcome measurement and analysis
- Data collection and reporting
- Accreditation and regulatory standards
|
| Topic 2: Healthcare Delivery Systems and Community Resources | 10% | - Community-based services and resources
- Healthcare policy and systems
- Continuum of care settings
- Interdisciplinary collaboration
|
| Topic 3: Psychosocial Concepts and Support Systems | 20% | - Family dynamics and support systems
- Cultural competence and diversity
- Abuse and neglect recognition
- Behavioral change theories and models
- Mental health and substance use considerations
|
| Topic 4: Reimbursement Methods | 12% | - Financial resources and negotiation
- Managed care and accountable care concepts
- Insurance principles and benefit structures
- Payment and reimbursement methodologies
- Coding and utilization review principles
|
| Topic 5: Care Management | 30% | - Evidence-based case management models and tools
- Medication management
- Care coordination and collaboration
- Age-specific care application
- Caseload assignment and selection criteria
- Cost containment principles
- Client-centered care plan development
|
| Topic 6: Ethics, Legal, and Practice Standards | 18% | - Advocacy and patient rights
- Scope of practice and roles
- Legal and regulatory requirements
- Confidentiality and privacy
- Professional ethics and conduct
|
Medical Professional Certified Case Manager Certification Exam (CCM) Sample Questions:
1. The details of all the matters that have been clarified and agreed between the Employer and tenderers during the tender stage are recorded by, for instance, a memorandum of understanding. The Employer may award the contract to the tenderer through a letter of formal acceptance, signed by the Employer. This process is in compliance with which one of the following Golden Principles (GP ' s)?
A) GP 1
B) GP 2
C) GP 3
D) GPA
2. You are the Contract Manager of the Engineer in a hotel project. In May 2020, the Employer and the Contractor signed a Contract based on the FIDIC Yellow Book (edition 2017), as per which the Contractor will design and build a hotel project with Contract Price of 5,100,000 USD. The Time for Completion for this project is 12 months (May 2021). The Contract also named a nominated Subcontractor (as referred to in Sub- Clause 4.5) who provides mechanical, electrical, and plumbing services for the project (including the fire fighting system), which was accepted by the Contractor without any discussions.
The Project was delayed due to issues with the fire fighting system, and you issued the Taking-Over Certificate in June 2022.
The Employer sent a Notice of Claim to the Contractor on Delay Damages with a maximum value equal to
10% of Contract Price (510,000 USD). The Employer also gave a Notice to the Contractor stating that the Contractor has failed to submit the evidence of payment to the nominated Subcontractor as well as the reason for withholding payment to the nominated Subcontractor. Therefore, the Employer has paid the nominated Subcontractor directly the entire amount due, coming to 100,000 USD. The Employer intends to include this amount as a deduction in the Final Payment to the Contractor.
As Contract Manager of the Engineer, you are tasked to make a fair determination of the Notices of the Employer. In your " Notice of the Engineer ' s determination " , what is your determination for the deduction of the next Interim Payment to the Contractor in relation to the amount directly paid to the nominated Subcontractor?
A) The Employer is entitled to deduct the amount directly paid.
B) The Employer is not entitled to deduct the amount directly paid.
3. (Both FIDIC Silver Book (SB) and Yellow Book (YB) (edition 1999) mention the Contractor scrutinising the Employer ' s Requirements. Which statement is correct?)
A) Scrutinising in FIDIC Silver Book 1999 means that the Contractor should read the Employer's Requirements very thoroughly after the contract closes and see if the Employer's Requirements is complete or if something is missing.
B) Scrutinising in FIDIC Yellow Book 1999 means that the Contractor has the opportunity after the contract close to report on any errors, mistakes or conflicts in the Employer's Requirements. In the FIDIC Silver Book 1999 scrutinising provides that obligation during the tender period; the Contractor has to review and verify the Employer's Requirements more strictly before submitting the tender.
C) Scrutinising in FIDIC Yellow Book 1999 means the same as in FIDIC Silver Book 1999; in both models it means that after the contract closes and before starting the actual making of the design, the Contractor has to read the Employer's Requirements very thoroughly and check on any errors, omissions or conflicts.
D) Scrutinising in FIDIC Yellow Book 1999 and Silver Book 1999 means that the Contractor must ask the Employer to check the Employer's Requirements very well to see if the Works can be built on that location according to the Employer's Requirements.
4. (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) 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.
B) The Contractor shall not be responsible for the acts or defaults of any Subcontractor.
C) The Contractor shall obtain the Engineer's and the Employer's prior consent to all Subcontractors.
D) The Contract Data may identify parts of the Works which the Contractor is not entitled to subcontract.
5. 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) If there is international financing for the project, it is always necessary to conduct a two-stage procurement procedure.
B) When the works are simple and of short duration.
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.
Solutions:
Question # 1 Answer: A | Question # 2 Answer: A | Question # 3 Answer: B | Question # 4 Answer: A,D | Question # 5 Answer: C |