CASE MANAGER CERTIFICATION EXAM
WITH 246 QUESTIONS AND CORRECT
ANSWERS RATED A+ 2026/2027
standards of care
parameters to measure the quality of healthcare
clinical guidelines
statements to help make decisions about health specific circumstances.
clinical pathway
structured multi-disciplined plan of care to support clinical guidelines and
protocol to improve continuity and coordination.
case management
the dynamic and systematic collaborative approach to providing and coordinating
health care services to a defined population.
- participative process to identify and facility options and services for meeting
individual healthcare needs while decreasing fragmentation and duplication of
care and increasing quality and cost effective clinical outcomes.
4 parts of clinical pathway
1. timeline
2. categories of care/activities and interventions
3. intermediate and long term outcome criteria
4. variance tracking
are 4 parts of what?
decision tree
used to select the best course of action in decisions where there is no clear
decisions.
,descriptive screening tool
identifies characteristics about a population to show health prevention.
predictive screening tool
shows what may happen to a specific population.
evaluative screening tool
evaluates the understanding/effectiveness
SF-36
predictive screening tool to assess functional health and well being. Assesses
physical and mental health.
- used in health economics, cost-effectiveness of health tx
-evals individual patient health status.
- does not consider sleep
-scored 00-100, lower score-> incr. disability
patient activation measure
13 item predictive screening tool to evaluate patient's knowledge, skills,
confidence in self-care.
- higher the score the better (scored 0-52)
-predicts health care outcomes, medication adherence and ER visits.
What part of Medicare covers skilled nursing facility?
B
What part of Medicare covers durable medical equipment?
Goals
1. Patient focused
2. Measurable
3. Attainable
4. Relevant
5. Time oriented
Piaget
,Developmental theory for cognitive ability to process/analyze information
Assess, plan, implement/intervention, monitor/evaluation
4 stages of case management
Sensorimotor: object performance and separation anxiety.
Piaget's age 0-2,
Preoperational: pretend, egocentric
Piaget's stage age 2-6
Concrete operational: logical, math, conservation
Piaget's stage 7-12
Formal operational: abstract, hypothetical
Piaget's stage 12-adult
Trust vs. mistrust
Erickson 0-1 1/2
Autonomy vs. shame
Erickson 1 1/5-3
Initiative vs. guilt
Erickson 3-5
Industry vs. inferiority
Erickson 5-12
Ego id vs. role confusion
Erickson 12-18
Intimacy vs. isolation
Erickson 18-40
Generative vs. stagnation
, Erickson 40-65
Integrity vs. despair
Erickson 65+
Skinner
Operational conditioning
CMAG
Case management adherence guidelines
IM-CAG
Inter med - complexity assessment grid
CMAG
assessment tool. Comprehensive approach to chronic therapy issues, ex: med
adherence, COPD, DVR,DM,HTN,
IM-CAG
Electronic tool that provides risks and vulnerabilities of complex patients with
actionable interventions.
4 domains: behavioral, social, health system.
evidence based practice
1. Question
2. ID resources
3. Critically appraise resources
4. Apply evidence
5. Reevaluate application of evidence
are 5 steps of what?
Integrated CM
Includes well being, disease management, case management, prevention, triage,
utilization management
Integrated case management
WITH 246 QUESTIONS AND CORRECT
ANSWERS RATED A+ 2026/2027
standards of care
parameters to measure the quality of healthcare
clinical guidelines
statements to help make decisions about health specific circumstances.
clinical pathway
structured multi-disciplined plan of care to support clinical guidelines and
protocol to improve continuity and coordination.
case management
the dynamic and systematic collaborative approach to providing and coordinating
health care services to a defined population.
- participative process to identify and facility options and services for meeting
individual healthcare needs while decreasing fragmentation and duplication of
care and increasing quality and cost effective clinical outcomes.
4 parts of clinical pathway
1. timeline
2. categories of care/activities and interventions
3. intermediate and long term outcome criteria
4. variance tracking
are 4 parts of what?
decision tree
used to select the best course of action in decisions where there is no clear
decisions.
,descriptive screening tool
identifies characteristics about a population to show health prevention.
predictive screening tool
shows what may happen to a specific population.
evaluative screening tool
evaluates the understanding/effectiveness
SF-36
predictive screening tool to assess functional health and well being. Assesses
physical and mental health.
- used in health economics, cost-effectiveness of health tx
-evals individual patient health status.
- does not consider sleep
-scored 00-100, lower score-> incr. disability
patient activation measure
13 item predictive screening tool to evaluate patient's knowledge, skills,
confidence in self-care.
- higher the score the better (scored 0-52)
-predicts health care outcomes, medication adherence and ER visits.
What part of Medicare covers skilled nursing facility?
B
What part of Medicare covers durable medical equipment?
Goals
1. Patient focused
2. Measurable
3. Attainable
4. Relevant
5. Time oriented
Piaget
,Developmental theory for cognitive ability to process/analyze information
Assess, plan, implement/intervention, monitor/evaluation
4 stages of case management
Sensorimotor: object performance and separation anxiety.
Piaget's age 0-2,
Preoperational: pretend, egocentric
Piaget's stage age 2-6
Concrete operational: logical, math, conservation
Piaget's stage 7-12
Formal operational: abstract, hypothetical
Piaget's stage 12-adult
Trust vs. mistrust
Erickson 0-1 1/2
Autonomy vs. shame
Erickson 1 1/5-3
Initiative vs. guilt
Erickson 3-5
Industry vs. inferiority
Erickson 5-12
Ego id vs. role confusion
Erickson 12-18
Intimacy vs. isolation
Erickson 18-40
Generative vs. stagnation
, Erickson 40-65
Integrity vs. despair
Erickson 65+
Skinner
Operational conditioning
CMAG
Case management adherence guidelines
IM-CAG
Inter med - complexity assessment grid
CMAG
assessment tool. Comprehensive approach to chronic therapy issues, ex: med
adherence, COPD, DVR,DM,HTN,
IM-CAG
Electronic tool that provides risks and vulnerabilities of complex patients with
actionable interventions.
4 domains: behavioral, social, health system.
evidence based practice
1. Question
2. ID resources
3. Critically appraise resources
4. Apply evidence
5. Reevaluate application of evidence
are 5 steps of what?
Integrated CM
Includes well being, disease management, case management, prevention, triage,
utilization management
Integrated case management
