CERTIFIED EMERGENCY MANAGER -
WEEK 5 EXAM QUESTIONS WITH 100%
CORRECT ANSWERS!!
Principles of Case Management Practice
focus on pt and family, negotiating, procuring and coordinating services and resources, use of
clinical reasoning, development of various relationships, episode or continuum based
Target Populations
diagnosis, high utilizers, age & health status, procedure, LOS, psychological factors, vocational,
functional impairments, disability
Case finding and intake
ID member, obtain consent, communicating member needs to others, ID members who need
alternate levels of care
Provision of services
facilitate and coordinate, communicate with other healthcare providers, monitor progress, review
and modify healthcare services, collaborate with stakeholders on CM plan, advocate for pt and
family, assure adherence to various standards
Evaluation and Case closure
collect, analyze and report data, evaluate quality of services, ensure access to services, apply
evidence based practices, close relationship when appropriate, report termination to stakeholders,
education pt re illness prevention
Utilization Management
evaluate appropriate level of care, communicate with payers and healthcare providers, allocate
resources, manage appeals and denials, review pt condition for appropriateness of
hospitalization, ID cases that are at risk for complications
Psychosocial & economic issues
, review pt social & financial resources, assess support network, consider culture, evaluate ability
of caregiver outside hospital setting, determine eligibility for insurance coverage or charity
services
Vocational issues
ID need for changes in home environment, eliminate access barriers, determine need for
specialized services, arrange vocational assessment and services, coordinate job analysis to
implement modifications, manage return to work activities
Clinical Patient Care Role
Discuss preventive services, direct patient care, asses coping skills, social supports,
financial/insurance status, intervene when problems ID'd, facilitate progress through healthcare
system, arrange for consultations with specialists, ensure transfer to appropriate levels of care,
collaborate with team
Managerial Leadership Role
Evaluate quality of care, conduct chart reviews for UM, guide care and interventions, facilitate
communication among team, serve as preceptor for CM's in training
Financial Business Role
Assess variances, ensure continuity, integration and coordinator to avoid duplication or
fragmentation, access information on case mix indexes, practice patterns, and consumption of
resources, ensure use of necessary treatments & completed procedures with reimbursable time
frames
Information Management-Communication Role
Data collection & analysis of variances, quality assurance, outcomes management,
communication and dissemination of information, generation of reports, presentation of
information, development and revision of policies and procedures, obtain authorization for
services from managed care organizations, reports findings of UM activities
Professional Development-Career Advancement Role
WEEK 5 EXAM QUESTIONS WITH 100%
CORRECT ANSWERS!!
Principles of Case Management Practice
focus on pt and family, negotiating, procuring and coordinating services and resources, use of
clinical reasoning, development of various relationships, episode or continuum based
Target Populations
diagnosis, high utilizers, age & health status, procedure, LOS, psychological factors, vocational,
functional impairments, disability
Case finding and intake
ID member, obtain consent, communicating member needs to others, ID members who need
alternate levels of care
Provision of services
facilitate and coordinate, communicate with other healthcare providers, monitor progress, review
and modify healthcare services, collaborate with stakeholders on CM plan, advocate for pt and
family, assure adherence to various standards
Evaluation and Case closure
collect, analyze and report data, evaluate quality of services, ensure access to services, apply
evidence based practices, close relationship when appropriate, report termination to stakeholders,
education pt re illness prevention
Utilization Management
evaluate appropriate level of care, communicate with payers and healthcare providers, allocate
resources, manage appeals and denials, review pt condition for appropriateness of
hospitalization, ID cases that are at risk for complications
Psychosocial & economic issues
, review pt social & financial resources, assess support network, consider culture, evaluate ability
of caregiver outside hospital setting, determine eligibility for insurance coverage or charity
services
Vocational issues
ID need for changes in home environment, eliminate access barriers, determine need for
specialized services, arrange vocational assessment and services, coordinate job analysis to
implement modifications, manage return to work activities
Clinical Patient Care Role
Discuss preventive services, direct patient care, asses coping skills, social supports,
financial/insurance status, intervene when problems ID'd, facilitate progress through healthcare
system, arrange for consultations with specialists, ensure transfer to appropriate levels of care,
collaborate with team
Managerial Leadership Role
Evaluate quality of care, conduct chart reviews for UM, guide care and interventions, facilitate
communication among team, serve as preceptor for CM's in training
Financial Business Role
Assess variances, ensure continuity, integration and coordinator to avoid duplication or
fragmentation, access information on case mix indexes, practice patterns, and consumption of
resources, ensure use of necessary treatments & completed procedures with reimbursable time
frames
Information Management-Communication Role
Data collection & analysis of variances, quality assurance, outcomes management,
communication and dissemination of information, generation of reports, presentation of
information, development and revision of policies and procedures, obtain authorization for
services from managed care organizations, reports findings of UM activities
Professional Development-Career Advancement Role
