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Exam (elaborations)

Case Manager Certification Exam 2025/2026 | Verified Study Guide, Practice Questions & Test Bank

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Prepare to succeed on the Case Manager Certification Exam 2025/2026 with this expert-verified study guide, featuring real exam-style questions, detailed answers, and core case management principles. This comprehensive resource covers patient advocacy, care coordination, interdisciplinary intervention, insurance and reimbursement systems, legal and ethical guidelines, and professional practice standards. Designed for healthcare and social service professionals, this Case Manager Certification Exam Study Pack provides the clarity, confidence, and exam-ready preparation needed to achieve certification on the first attempt.

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Uploaded on
November 27, 2025
Number of pages
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Written in
2025/2026
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Case Manager Certification

2025/2026
Exam Prep Material
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Verified Questions and Answers
A+ Grades Guarantee

, 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
case management fragmentation and duplication of care and increasing quality and
cost effective clinical outcomes.




standards of care parameters to measure the quality of healthcare

statements to help make decisions about health specific
clinical guidelines circumstances.

structured multi-disciplined plan of care to support clinical
clinical pathway guidelines and protocol to improve continuity and coordination.

1. timeline
2. categories of care/activities and interventions
3. intermediate and long term outcome criteria
4 parts of clinical pathway 4. variance tracking
are 4 parts of what?



used to select the best course of action in decisions where there is
decision tree no clear decisions.

identifies characteristics about a population to show health
descriptive screening tool prevention.


predictive screening tool shows what may happen to a specific population.

evaluative screening tool evaluates the understanding/effectiveness

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.
SF-36 - does not consider sleep
-scored 00-100, lower score-> incr. disability



13 item predictive screening tool to evaluate patient's knowledge,
skills, confidence in self-care.
- higher the score the better (scored 0-52)
patient activation measure -predicts health care outcomes, medication adherence and ER
visits.



predictive screening tool: patient's self assessment of their health
and how likely they will seek care.
- predicts future health costs
- predicts likely-hood of progression of their illness to a worse
health risk assessment condition.
- examples: PHQ-9, etc.

, health risk assessment for angina, MI, coronary heart disease.
defined angina pectoris as, "a chest pain or discomfort with these
characteristics:
(a) the site must include either the sternum (any level) or the left
arm and left anterior chest (defined as the anterior chest wall
between the levels of clavicle and lower end of sternum),
(b) it must be provoked by either hurrying or walking uphill (or by
walking on the level, for those who never attempt more),
(c) when it occurs on walking it must make the subject either stop
or slacken pace, unless nitroglycerin is taken, (d) it must disappear
on a majority of occasions in 10 min or less from the time when the
rose Q subject stands still."

Possible myocardial infarction1 was defined as, "one or more
attacks of severe pain across the front of the chest lasting for 30
min or longer."




19-item self-administered health risk assessment for angina and
functional artery disease measuring five dimensions of coronary
artery disease:
1 physical limitation, 2 anginal stability, 3 anginal frequency, 4
treatment satisfaction and 5 disease perception.
seattle angina questionnaire
-score of 0 to 100, where higher scores indicate better function
(eg, less physical limitation, less angina, and better quality of life).




health risk assessment: Disease-specific measure of physical,
social, and emotional well-being designed as a measure of
outcome in arthritis.
-scales: mobility, physical activity (walking, bending, lifting),
dexterity, household activity (managing money and medications,
housekeeping), social activities, activities of daily living, pain,
depression, and anxiety.
arthritis impact measurement Score range: Range is 0-10 for each section. Total health score 0-
scales 60.
--> Zero represents good health status, 10 and 60 represent poor
health status.




health risk assessment: Cancer-specific, functionally-oriented
quality of life instrument.
-22 items assessing 5 domains: Physical well-being and ability,
functional living index-cancer emotional state, sociability, family situation, nausea
- Higher score indicates better quality of life.

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