Certified Case Manager (CCM)

To earn the credential Certified Case Manager (CCM), work experience is required, examples include:

• Design and monitor care plans.
• Coordinate care among different physicians for the same patient.
• Advocate for a patient in his communication with family, physicians, insurance companies, hospitals, and other parties.
• Evaluate a patient's progress and revise the care plan as needed.
• Track the outcomes of a patient's well-being, overall satisfaction of the patient and his family with his care, and cost savings.

In order to be eligible to take the CCM examination, the following are required:

• A minimum of a nursing diploma or an associate degree in a field that promotes physical, psychosocial, or vocational well-being.
• The ability to practice the duties of a CCM without supervision.

The employment experience requirement can be fulfilled in one of three ways:

• One year of acceptable full-time case management employment experience under the supervision of a CCM,
or
• Two years of acceptable full-time case management employment experience,
or
• One year of acceptable full-time case management employment experience as a supervisor of others who provide case management services.

Good moral character is necessary to take the CCM examination. Any of the following scenarios may bar an applicant from taking the CCM examination:

• A license or certification revoked, or disciplinary action taken by a licensure or certification body.
• A reprimand or discharge by an employer or supervisor because of dishonesty on the job.
• A felony conviction.
• Convicted of any crime involving drugs or alcohol.
• Convicted of sexual assault, sexual abuse, or molestation.
• Received or offered a grant of immunity in a grand jury proceeding.
• Use of a CCM designation without completing the proper credential requirements.

The CCM examination contains 180 multiple-choice questions. An outline of expected content is presented below for review and to aid in test preparation:

Psychosocial aspects: 20 percent (30 questions)

Abuse and neglect
Multicultural issues as they relate to health behavior
Psychological and neuropsychological assessment
Psychosocial aspects of chronic illness and disability
Self-care management
Health coaching
Spirituality as it relates to health behavior
Substance use, abuse, and addiction
Support groups
Wellness and illness prevention, concepts and strategies
Behavioral health and psychiatric disability concepts
Community resources
Crisis intervention strategies
Change theories and stages
Dual diagnoses
End of life issues
Family dynamics
Health literacy assessment

Healthcare reimbursement: 15 percent (23 questions)

Cost containment principles
Financial resources
Health insurance principles
Managed care concepts and rules for reimbursement
Private benefit programs
Prospective payment systems and rules for reimbursement
Public benefit programs
Resources for the uninsured or underinsured
Utilization management

Rehabilitation: 5 percent (7 questions)

Work adjustment, transitional employment, and work hardening
Workers' compensation
Assessment of physical functioning
Disability compensation systems
Assistive devices
Ergonomics and assistive technologies
Functional capacity evaluation
Job analysis, job modification, and job accommodation
Job development and placement
Vocational aspects of chronic illness and disability

Healthcare management and delivery: 20 percent (30 questions)

Alternative care facilities
Management of acute and chronic illness and disability
Medical home model
Medication therapy management and reconciliation
Models of care
Palliative care and symptom management
Rehabilitation service delivery symptoms
Roles and functions of other providers
Transitions of care
Continuum of care
Critical pathways, standards of care, and practice guidelines (including the average duration of treatment associated with various conditions and disabilities)
Healthcare delivery systems
Chronic care model
Healthcare providers, including vendors available in the community
Interdisciplinary Care Team (ICT)

Principles of practice: 15 percent (23 questions)

Accreditation standards and requirements
Ethics
Healthcare and disability related legislation
Legal and regulatory requirements
Risk management
Standards of practice
Quality indicators
Confidentiality

Case management concepts: 25 percent (37 questions)

Goals and objectives of case management practice
Interpersonal communication
Interview techniques
Management strategies for clients with multiple co-morbidities
Roles and functions of case managers in various settings
Negotiation techniques
Cost-benefit analysis
Data interpretation and reporting
Program evaluation and research methods
Case recording and documentation
Quality and performance improvement concepts
Conflict resolution strategies
Factors used to identify acuity or severity levels
Case load calculation
Case management models
Case management process and tools