Certified Case Manager (CCM) MCQ Flashcards
7 cards from real CCM practice questions. Tap to flip, then mark Knew It or Still Learning — missed cards come back until you master them.
Read the first 7 Certified Case Manager (CCM) MCQ flashcards as text
A case manager is coordinating care for a patient transitioning from an acute care hospital to a skilled nursing facility. Which action BEST supports a safe transition?
Answer: Conducting a warm handoff with medication reconciliation and follow-up scheduling
A warm handoff including medication reconciliation and follow-up scheduling reduces readmission risk and ensures continuity of care.
Which ethical principle is most directly applied when a case manager ensures a patient understands all treatment options before agreeing to a care plan?
Answer: Autonomy
Autonomy supports the patient's right to make informed decisions about their own care.
Under the CCMC Code of Professional Conduct, a case manager who receives a gift from a vendor should:
Answer: Report it to a supervisor and decline per conflict of interest policies
CCMC standards require case managers to avoid conflicts of interest, including declining gifts from vendors regardless of value.
A patient with congestive heart failure is being discharged home. Which community resource is MOST appropriate for daily symptom monitoring?
Answer: Telehealth remote patient monitoring program
Remote patient monitoring programs allow daily tracking of weight, blood pressure, and symptoms to detect CHF decompensation early.
Utilization management in case management primarily aims to:
Answer: Ensure the appropriate level of care is used at the right time to optimize outcomes and resources
Utilization management ensures care is medically necessary, delivered at the appropriate setting, and aligned with evidence-based criteria.
A case manager identifies that a patient's insurance plan requires prior authorization for a recommended MRI. The MRI is urgently needed. The BEST action is to:
Answer: Initiate a peer-to-peer review or expedited appeal with clinical documentation
Initiating an expedited peer-to-peer review with clinical justification is the appropriate step to secure timely authorization.
Which tool is most commonly used by case managers to screen for social determinants of health (SDOH)?
Answer: PRAPARE or AHC-HRSN screening tool
PRAPARE and AHC-HRSN are standardized SDOH screening tools designed to identify unmet social needs like housing and food insecurity.