About the Exam

The examination consists of 200 multiple-choice questions focusing on vocabulary, concepts, and application of managed care in today’s healthcare environment. The examination must be completed within four hours. It is closed book and proctored. It can be taken by paper or computer. The exam sitting fee is $250.

If the candidate requests a paper exam, the candidate’s exam date must be at least seven business days after the proctor form is received by ABMCN. Examinations are sent by Federal Express to the Proctor and are to arrive three business days prior to the examination date. If the candidate requests an online exam, the candidate’s exam date must be at least five business days after the proctor form is received by ABMCN. Examination instructions are sent via email to the Proctor two business days prior to the examination date. Please plan accordingly.

There is no excuse for cheating. Should such an incident occur, the candidate is to be excused from the room, and their exam score will be zero. There will be no refund of any fees, nor will they be permitted to take the exam again.

Eligibility

Please be advised that in order to take this examination, you must meet all eligibility requirements: CMCN/CMCP candidates must hold a current valid medical license (e.g. RN, LPN, LCSW, LPC, etc) in an American State, territory, or protectorate. You will need your license number to complete the application. Further, CMCN/CMCP candidates must either complete A Comprehensive Introduction to Managed Care Nursing self-study program available from the AAMCN, or they may submit a resume to the ABMCN Board of Directors (via jbeilhart@abmcn.org) that attests to a significant background in managed care.

Proctor

Your proctor can be:

  • A proctor you arrange for yourself

    • Through work—supervisor, human resources representative, or education representative

    • Through testing services with a local library, college, university, or testing center

    • Who is a current CMCN/CMCP

  • ExamRoom.AI, our third party proctor

    • Webcam & stable internet connection required

    • Online exams only

    • Additional $25 charge

  • ABMCN at one of our Managed Care Forums

    • Paper exams only

    • Additional $25 charge

Proctors must agree to the following:

  • Not taking the CMCN/CMCP exam after acting as proctor

  • Keeping all materials and knowledge gained during the process completely and totally confidential

  • Overseeing the examination continuously for a period of up to, but not more than four hours (candidates are not to be left unsupervised with the exam materials) and assuring that the candidate is in a secure environment (i.e. away from papers relevant to managed care, cell phones, people, and other possible distractions)

If the candidate requests to take the exam on paper, the exam materials will be Fed-Exed to arrive at the proctor’s location three business days prior to the exam date. If the candidate requests to take the exam online, the proctor will be emailed the exam instructions two business days prior to the exam date. Examination materials will only be sent to the proctor and never the candidate.

Submit Proctor Form

After Sitting The Exam

A passing score of 70% or higher is required to earn the certification. Exam scores are confidential. We send out pass/fail notification via email within two business days of receiving the exam. Exams taken by computer we receive as soon as you finish it. For paper exams, it just depends on when it gets back to us (they are sent via FedEx, so about a week if the proctor sends just after the exam is sat).

You will have three years beginning July 1 or January 1 (whichever comes first) following your passed examination before you need to renew your credential. To renew, you will need 25 CEUs from this three year period in addition to a $55 renewal fee. Your medical license must remain active to renew your certification. Accepted CEUs come from a broad range of topics that apply to managed care. See our renewal page for more information.

Content of the Examination

The examination consists of four parts: Managed Care Overview, Healthcare Administration, Healthcare Management, and Law & Ethics, which are to test mastery over standard managed care topics. A condensed content outline of the certification examination is shown below.

    1. Possess an overview of Managed Care

    2. Understand the spectrum of roles for nurses in managed care

    3. Describe the history of healthcare as it relates to the development of Managed Care

    4. Identify significant milestones, concepts and laws

    5. Understand the constant evolution of Managed Care

    6. Identify different types of government coverage & products

    7. Identify some of the benefits of governmental managed care products

    8. Recognize and describe the major components of and differences within government managed care models

    9. Identify types of commercial managed care products

    10. List examples of commercial managed care product coverage & benefits

    11. Describe major components of and differences within commercial managed care models

    1. Define negotiation, why it matters, and its parts

    2. Identify tools to use/develop for successful negotiation

    3. Understand how to prepare for a negotiation

    4. Identify how to have a successful negotiation in the healthcare environment

    5. Define basic managed care reimbursement terminology

    6. Explain the relationship between types of provider reimbursement

    7. Identify trends in reimbursement methodologies

    8. Understand impacts on care delivery and outcomes

    9. Describe the history of health information technology

    10. Identify the use of medical and clinical informatics in managed care

    11. Discuss the nurse’s role in health information technology and informatics

    1. Identify and define the multiple components of a utilization management program

    2. Compare the elements of the utilization management process

    3. Compare the elements that comprise the quality management/improvement process within utilization management

    4. Recognize the fundamentals of utilization management and quality management/improvement as they impact the delivery of cost-effective quality care

    5. Recognize the current accreditation bodies

    6. Understand the implications of accreditation

    7. Know how accreditation affects managed care

    8. Identify how provider profiling can summarize practice patterns that lead to improved provider performance

    9. Explain why reliability measurement is an important component in evaluating a profile system

    10. Examine the effect of provider profiling on the quality of care and disease management

    11. Describe the fundamentals of Quality Management and improvement programs

    12. Identify basic quality improvement principles and activities used in a managed

      care setting

    13. Understand the importance of quality performance

    1. Identify various laws and rules that affect the managed care nurse’s role

    2. Describe the managed care nurse’s role in maintaining compliance and managing risk

    3. Identify methods of dispute resolution

    4. 􀀤Describe the differences between principles, values and ethics

    5. Describe the ethical decision-making model of nursing

    6. Discuss pertinent issues from an ethical perspective

Apply

Have a question?

If you need additional information, check out our FAQs. Question not answered there? Please don’t hesitate to get in touch. We look forward to connecting with you.

Get In Touch