Case managers have one of the most significant jobs in the medical field. Their duties and responsibilities are numerous and broad. They coordinate healthcare and recovery plans for patients in critical conditions stemming from illness or injury. They must have thorough knowledge of many specific diseases and conditions and the appropriate treatments for those conditions. The case manager decides what needs to be done for a particular patient, assigns duties to a team of professionals that will care for the patient, and oversees every step of treatment to ensure that everything is going smoothly and according to plan.
The Certified Case Manager (CCM) exam is an option medical case managers have to increase their credentials in the work place and further ensure their capabilities to safely deal with serious medical situations. The CCM exam tests over six main areas of content. These are psychosocial aspects, which constitutes 20% of the exam material (30 questions), healthcare reimbursement, which constitutes 15% of the exam material (23 questions), rehabilitation, which constitutes 5% of the exam material (7 questions), healthcare management and delivery, which constitutes 20% of the exam material (30 questions), principles of practice, which constitutes 15% of the exam material (23 questions), and case management concepts, which constitutes 25% of the exam content (37 questions). Overall there are 180 questions on the exam, but only 150 of these questions will count towards the test taker’s final score. The other 30 questions are pretest questions. The format is multiple-choice, and the time limit is 3 hours, although test takers will need to arrive about an hour early. The exam is taken over a computer and is not offered in a paper and pencil format.
To take the exam you will first have to determine whether or not you are eligible. If you meet eligibility requirements, you will complete the registration process for the exam over the internet. Eligible candidates will receive an Authorization to Test (ATT) or eligibility identification number. With these they can register online at the website for Prometric, which is the body administering the test. Once you receive one of these forms of eligibility verification, you’ll enter the appropriate information on the Prometric website along with a valid email address. You can then register for a test time at one of many testing locations located across the country, after which you will await confirmation of your registration. Be aware that there are several fees you will have to pay. There is a fee of $150 for applying and a fee of $175 for the exam itself. If you miss the appointment you registered for, you will incur additional fees, and if you choose to reschedule your appointment but are late in doing so (within a 30 day range of the test date), you’ll have to pay another fee. There is also a fee for having your exam re-scored.
On the day of the exam you should arrive early at the testing location with a current government-issued photo identification, such as a driver’s license or passport. While you may need pencils and scratch paper for taking the exam, you do not need to bring these yourself, as they will be provided by the exam proctors. They will have earphones on hand for any test takers wanting an extra quiet environment while they are taking the exam. Do not bring a calculator, as you will not be allowed to use it.
After you finish the exam, you will be notified immediately on your computer monitor whether you have passed or failed. If you pass, you will get your CCM certificate by mail within 4-6 weeks. If you do not pass, you will be mailed a more detailed summary of your score within 2 weeks. This summary will give your scores for individual content areas. If you fail, you can have your exam re-scored or send in a new application and fees to register for the test again.
CCM Exam: Eligibility and the Application Process
To ensure that test takers have the highest potential for successfully completing the Certified Case Manager (CCM) exam, and to ensure that the CCM credential is not being offered to individuals of low character who will not uphold the standards of excellence implied by this title, certain requirements must be met for a candidate to prove eligible for taking the exam. There are three areas of eligibility you must pass through to qualify. These are holding a relevant license/certification prior to applying, work experience, and moral and ethical character.
Being licensed or certified implies that you are qualified to work as a case manager. This means completing training and receiving an Associate’s degree or higher. This may be obtained at a technical school or community college. The degree must be within the medical field and related to your specific area as a case manager. If you have obtained your license or certification, you have had the appropriate educational training you need to do well on the CCM exam. You also have met the minimum requirements for holding a job as a case manager, which you must do for some time before you can take the CCM exam. Someone wanting to pursue a career as a case manager but not yet employed cannot take the exam. Not only does your license or certification need to come from a legitimate, government-sanctioned school, but it also must imbue you with the right to practice your job on your own, without another licensed case manager working over you.
Work experience is a major part of the criteria for qualifying for the CCM exam. There are three different routes for qualifying on this level. You can work for 12 months as a case manager on a full-time basis with a CCM working over you and supervising you. You can work for 12 months as a case manager supervisor to other case managers on a full-time basis. In this case, you need not have any supervision of your own. You also can work for 24 months on a full-time basis as a case manager without supervising others or being supervised yourself.
You will have to demonstrate your moral character by satisfactorily answering several questions in your application to qualify for the exam. Some of the questions you get may ask if you have ever been reprimanded or fired, if you have ever been dishonest in the work place, if you have ever used the CCM credentials without authorization, or if you have ever been convicted in a court of law for the possession or distribution of drugs. Your answers to these questions should be totally honest, but be aware that they can have an effect on your eligibility.
If you meet all eligibility requirements, you can apply for the CCM exam. The application process is simple and straightforward. You can apply online at the website for the Commission for Case Manager Certification (CCMC). You will fill out the applications by providing the appropriate information as indicated by the instructions on the online form. If you have any difficulties, you will be provided with a number you can call to get step-by-step help. After you fill out the application, you can send it in with the click of a button.
Next, you should mail all appropriate fees. These will include an application fee and an examination fee. You also have to send in several pieces of information verifying your eligibility to take the exam. Talk to your employer and get them to send in documentation verifying your employment status and your licensure. This can be done by mail or fax. Contact information for each of these requirements can be found at the CCMC website. You will then be notified through your application account at the CCMC’s website if you have been approved to sit for the exam.
CCM Exam: Study Strategies
Appropriate study strategies vary from one test to another. For some you’ll need to spend time memorizing facts and dates, and for others you may be expected to think more abstractly. Flashcards may be best for preparing for one exam, and working practice problems may be better for others. The Certified Case Manager (CCM) exam covers a broad range of material, and given the volume of information you will be expected to be familiar with, you may want to try several different approaches to studying.
As soon as you decide to take the CCM exam, write a schedule out. The way you allot your time will depend on how long you have until the test date, but if you have long enough, you should plan to spend months studying. There are six content areas on the CCM exam: psychosocial aspects, healthcare reimbursement, rehabilitation, healthcare management and delivery, principles of practice, and case management concepts. Plan to spend at least one month of in-depth study of each of these topics. Schedule set times for study each day. For example, set aside two hours in the mornings and two hours in the evenings for study. At the end of the week, schedule a day for review of all you have absorbed in the previous week. You may also want to implement a reward system in conjunction with your schedule. If you complete your weekly schedule as planned, you can order pizza and watch a movie. If you complete your monthly schedule for one of the content areas, take a Sunday off from studying to relax. Plan a bigger reward for when you reach your goal of passing the exam after months of daily hard work.
Gather together the material that is most appropriate for your study. If you have old textbooks or notebooks from your case management training program in college, pull those out and start refreshing your memory. Go to the website for the Commission for Case Manager Certification (CCMC) for a list of reference books that would be especially useful in preparing for the exam. While the CCMC does not put out or endorse any particular study guide, there are some sold over the Internet by various companies. Order a study guide and add it to your study material in order to get a better idea of which information in your textbooks and reference books will be most likely to appear on the exam. This will help you focus your attention and avoid wasting time on topics that you probably will not be tested on.
As you are reading through your study material, highlight any information that may be relevant. After you finish studying for the day, go back through everything you have highlighted and determine which facts you feel positive could appear on the test. Make flashcards using this information. Review your flashcards every morning before you begin your day’s study and every night as you finish. If you are using a textbook in your preparation, write one to two paragraphs describing the high points of each individual chapter as you finish reading them to be sure you have really comprehended what you just read.
If you know any other people taking the CCM exam, set up a study group. In your study group, compile a definitive study guide for each content area of the test based on the notes taken by each individual in their own study. Review the study guide together, comparing problem areas and strengths and helping each other as needed. One option you have with a group that you would not have on your own is playing a study game. Using flashcards, notes, textbooks, and the study guide you made together, divide into two teams and play a quiz game. You’ll learn as you’re playing and your mind will be less likely to be wandering or fighting boredom.
Passing the CCM exam is the first and biggest obstacle you must get over in order to be certified. You may pass it the first time or it may take you several tries, but once you do pass the exam, you need to be aware that your education is not over. Your certification expires every five years, and before that time you will have to carry out the proper procedure for renewing your certification. Otherwise, you will lose your title and credential. There are two routes you can take to becoming recertified. You can take the CCM exam over again, or you can log 80 hours of continuing education.
The procedure for recertifying by taking the CCM exam will be familiar if you remember applying for a testing spot the first time. You will send in an application through the website for the Commission for Case Manager Certification (CCMC), fax in proof of your licensure, and get your employer to fax in documentation verifying your employment status. You’ll pay the appropriate fees ($200 for the application and $185 for the examination) and upon receiving approval you will register for a test date and location. The test will be the same format and length, and will cover the same content as the test you originally took. The only difference will be the questions themselves.
If you choose to recertify through continuing education, you will need to finish all of your 80 hours of coursework before the five year mark is up. You can accumulate your credit hours through taking or instructing a workshop (which can be employer-sponsored or put on by an external organization), attending and speaking at seminars and conferences related to your job as a case manager, or attending courses provided by a local community college. You can find a list of CCMC-approved continuing education providers at the website for the CCMC. If you are still uncertain about something you want to log as a credit, ask the sponsor of the program you are participating in. When no other information is available, it is generally safe to assume that if you are participating in something related to your job description but outside of work, it will probably count. If you choose the continuing education route for renewing your certification, you will have to pay a fee of $150.
It is up to you to decide which method of recertification is best for you. Continuing education is stretched out over a longer period of time, but it does not require the intense study that is involved in preparing for the CCM exam. Make your decision based on the costs and benefits of each method.
If you do not recertify before the five year benchmark, there are three options available to you. If a death, medical emergency, or something to that effect has hindered you from sending in all necessary information on time, you can provide documentation of your situation and submit a late renewal request. Note that in order for this to work you not only have to have a good reason for having missed the deadline, but you also have to submit your late renewal request within 30 days of your passed recertification deadline. You can also proceed through an appeals process for a second chance at sending in your recertification material. Be aware that it is rare for the appeals process or late renewal request to work, and even when they do, they take a good deal of time to be processed. If the appeals process or late renewal request work, that does not mean you are recertified. You still will have to either take the CCM exam or provide documentation of 80 hours of continuing education. If these methods fail, are not available to you (because you didn’t have a good reason for missing the deadline), or do not appeal to you, you can reapply for the certification exam.
CCM Exam Content: Areas I & II
The Certified Case Manager (CCM) exam tests over six major content areas. These are psychosocial aspects, healthcare reimbursement, rehabilitation, healthcare management and delivery, principles of practice, and case management concepts.
The psychosocial content area makes up 20% of the overall test. There will be 30 questions drawn from this area. As a case manager you must have a vast store of information in your memory that you can call up on a moment’s notice. You’ll have to know about simple medical procedures, basic first aid, diseases (both common and rare) and their processes, and specific treatments for specific medical problems. On top of knowing many aspects of the theory and practice of medicine, you will also have to know how to deal with your patients. This area deals with the emotional health of a patient and the psychological factors that affect health.
You may receive questions about the impact of verbal and physical abuse on a patient—their emotional state, the way such abusive treatment informs their reactions to medical treatment, and the trust issues they may have with authority figure. Religion and spirituality as they affect health behavior may come up. This may be in the form of a question on how a member of a certain religion may feel about certain treatments or a question on how prayer and meditation can play a part in easing pain. Know about the psychological impact of chronic pain and illness and activities you can implement to take the patient’s mind off of the pain temporarily. Questions may arise on the effects of drug and alcohol abuse and how a cycle of dependency may need to be taken into consideration with the treatment plans you put in place. Expect questions on dealing with family members of patients and giving emotional support to terminally ill patients.
Education will also come into play in the psychosocial aspects content heading. As a case manager, you will need to be capable of teaching patients how to care for themselves by performing certain procedures at home. In the case of patients who cannot do for themselves, you will need to be able to teach family members how to help out. This is not limited to actual medical procedures. Patients and family members of patients who are critically ill may need to be taught methods for relaxing their mind and bolstering positive attitudes. There is a good chance you will receive questions dealing with these aspects of education on the CCM exam.
The healthcare reimbursement content area of the CCM exam will account for 15% of the overall test material, or 23 questions. As a case manager, your first priority is the recovery and rehabilitation of patients in need of critical attention, but once the healing process begins, many families will be confronted with an overwhelming financial burden they will not know how to face. This portion of the exam tests on approaches you can take to help families and patients with financial costs. You’ll get questions dealing with insurance plans and how they work and potential resources for patients who do not have insurance or whose insurance plans will not cover the bulk of expenses. You’ll also get questions on private and public benefit programs that may be available to patients. Private benefit programs may include coverage sponsored by a patient’s employer, pharmacy benefits management, or home care benefits. Public benefit programs may include Medicare, Medicaid, or SSI. Patients can be put on payment plans that may ease their financial worries somewhat. You may receive questions on how to decide on an appropriate payment system for a particular patient’s situation, how to implement that system, and how to ensure that it will work for all parties involved, both patients and medical care providers.
The next four content areas cover rehabilitation, healthcare management and delivery, principles of practice, and case management concepts.
CCM Exam Content: Areas III & IV
The first two content areas of the Certified Case Manger (CCM) exam are psychosocial aspects and healthcare reimbursement. Areas III & IV are rehabilitation and healthcare management and delivery. Each of these content areas branch out into several subsections of potential question topics. Prepare yourself as much as possible for the CCM exam by informing yourself thoroughly of the more specific topics that may fall into these areas.
The rehabilitation portion of the exam counts for 5% of the overall exam material, which comes out to be 7 questions. This may not seem like much, but keep in mind that you are not only studying to pass the exam. You are studying to broaden your knowledge so that you are more qualified to safely administer healthcare treatments and put recovery plans into place. It is to your benefit to learn as much as you can in this category even if it does not make up a significant portion of the test material.
This section of the exam essentially deals with what comes after treatment for a patient. After some time has passed and they have proven healthy enough to continue on their own at home, they will be discharged from the hospital, and it will be your job as case manager to make sure they smoothly enter back into regular life with the right adjustments where necessary. You will be responsible for evaluating their physical condition and determining the best methods for them to continue the healing process on their own. This may mean teaching them certain exercises that will promote healing or recommending devices that will help them with basic body mechanics. You’ll decide how often they need to come in for appointments to monitor their progress and how best to ascertain whether or not they are progressing as they should.
The other aspect of rehabilitation that will be covered on the exam is helping patients segue back into the working world. You’ll decide whether they are fit to continue with the vocation they currently have, and if they are, how they need to make the transition back into working on a full-time basis. Some patients may qualify for workers’ compensation, which could be a big help during their recovery time. You’ll need to be able to inform them about workers’ compensation and answer any questions they have. If patients are not fit to continue with the job they originally held, you will need to talk to them about vocational directions they would be better off to take put them in contact with the appropriate people to help with job placement. Be prepared for questions dealing with any of these subtopics and related topics dealing with rehabilitation.
Healthcare management and delivery is the fourth content area of the CCM exam, and it makes up 20% of the test, coming in at 30 questions. This category deals with the healthcare providers themselves and the different levels at which healthcare can be administered. Expect questions touching on different types of medical facilities and the models of healthcare provided by different facilities and different levels within a single facility. Know about the practice guidelines for these various facilities (they can vary from hospitals to group homes) and how these will be modified from one patient’s particular case to another’s. Questions may test on your management abilities—how well you can lead a team of professionals working for a patient with a given condition, how your leadership will differ from one case to another, and how you will work with your team for the transfer of the patient to another healthcare facility if and when this becomes necessary. Remember, as an overseer of recovery plans, your job requires management skills, and this content area will determine how qualified you are on that level.
The last two content areas covered in the CCM exam are principles of practice and case management concepts.
CCM Exam Content: Areas V & VI
The first four content areas of the Certified Case Manager (CCM) exam are psychosocial aspects, healthcare reimbursement, rehabilitation, and healthcare management and delivery. The two remaining content areas are principles of practice and case management concepts. These sections deal with your managerial skills, both in theory and in practice.
Area IV of the CCM exam, principles of practice, constitutes 15% of the overall exam material. There are 23 questions drawn from this area. This area deals mainly with standard guidelines and ethics in the work place. Not only will you be held accountable for your patient’s health and recovery, but you will also be held accountable for how you carry out your job and your treatment of patients and their families. Questions from this portion of the exam may test your understanding of patient / caregiver confidentiality, the legal regulations that accompany your job title, and the standards you must uphold to maintain accreditation. You’ll get questions on how to identify risks in the work place that you are responsible for addressing and the proper protocol for eliminating those risks.
Ethics is the biggest part of this exam section. You are responsible for working with terminally ill patients with the utmost of sensitivity to their situation. Informing them of their situation, monitoring the progress of their disease or condition, and doing all that is possible to make them comfortable and provide emotional or spiritual support during their final days comes under your job description. You must always maintain a professional disposition, keeping in mind the age of your patient when you are talking to them and avoiding inappropriate jokes or comments, both to your patients and your fellow medical professionals. You must also make difficult decisions regarding the ethical nature of a plan of treatment. Experimental procedures that will prolong pain with highly uncertain chances of actually paying off in the end may be considered cruel and unjustified. It is your job to advise a patient about when the benefits outweigh the disadvantages of a procedure. These examples constitute some of what you might see in the portion of your exam covering principles of practice.
The final content area of the CCM exam is case management concepts, which accounts for 20% of the material presented on the test. There will be 37 questions from this area on the test. This section holds the most weight on the exam, so you should make the study of relevant material from it your top priority. You will be given questions on the proper procedures for certain situations and the tools you would need to successfully carry out those procedures. You’ll demonstrate your ability to weigh the pros and cons of different situations in terms of financial cost, the potential for patient recovery, and the differences between various approaches to a single medical problem. Questions may test your ability to conduct interviews, your communication skills with patients and other medical professionals alike, and your grasp of different methods of negotiating. As a case manager, your job will not be as simple as making a plan for the recovery of a patient and telling your team of medical professionals to get to work. You will need to be able to choose the best route to take in helping a patient. Once you decide on a plan, you must monitor it to determine whether or not it is proving effective. This also includes deciding on the best method of monitoring treatment efficiency among a number of different options before you can even start. If a plan is not going as you would like, you’ll need to modify it or change its direction altogether. This content area, case management concepts, tests for your interpersonal skills and problem-solving abilities more than the other sections.