Certification

The CPMSM exam addresses the following objectives. Candidates are required to demonstrate proficiency on the exam by answering questions that evaluate their knowledge of facts, concepts, and processes required to complete the tasks described under each major objective listed below.

Accreditation and Regulatory Compliance (23%)

• Serve as the organization’s expert regarding relevant accreditation and regulatory requirements by applying current knowledge of published standards in order to ensure ongoing compliance.

• Develop governance documents (e.g., bylaws, policies, procedures) consistent with current accreditation and regulatory standards in order to ensure quality patient care.

• Implement a periodic review process for bylaws, policies, and procedures consistent with organizational policy in order to ensure ongoing compliance with accreditation and regulatory requirements.

Management of Credentialing Processes (23%)

• Develop organizational credentialing policies in accordance with regulatory and accreditation standards in order to provide a comprehensive and fair process.

• Apply the credentialing process uniformly to all practitioners/providers in accordance with organizational policies in order to address all stakeholder interests.

• Compile data required for the uniform assessment of practitioners/providers as determined by organizational policy in order to support the evaluation of current competency.

• Verify the status of all practitioner/provider expirables (e.g., licenses, certifications, insurances) by querying primary sources in order to validate currency and to ensure ongoing eligibility with the organization.

• Verify the absence of sanctions and complaints for all practitioners/providers by researching appropriate sources in order to ensure ongoing eligibility with the organization.

• Report adverse actions taken against a practitioner/provider by notifying the appropriate authorized agency in accordance with applicable law in order to protect the public.

Privileging (23%)

• Develop clinical privilege criteria based on established standards of practice (e.g., specialty boards, societies, organizations) and community standards of care through consultation with appropriately qualified individuals in order to ensure quality of care.

• Review requested privileges uniformly for all applicants using established criteria based on education, training, and experience in order to ensure current competency.

• Assess the applicability and appropriateness of clinical privileges for each specialty through periodic review in order to ensure currency, relevance to the facility, and accepted standards of care.

Medical Services Administration (12%)

• Facilitate meetings through agenda development, maintenance of a complete and accurate record of discussions and actions, and appropriate follow up in order to ensure compliance with accreditation, regulatory, and organizational requirements.

• Facilitate Continuing Medical Education programs by offering current clinical topics for practitioners/providers in order to comply with regulatory guidelines.

• Administer management responsibilities as they pertain to medical services in accordance with the organization’s policy in order to evaluate productivity, performance, staffing, budget, and planning needs.

• Provide an introduction to the organization through orientation and leadership education for practitioners/providers, medical services staff, and other stakeholders in order to comply with regulatory requirements, provide smooth transitions, and ensure succession planning.

• Participate in organizational initiatives by serving on committees, providing expertise on medical services topics, and advising on accreditation and regulatory issues in order to maintain compliance.

• Support organizational goals by planning for future recruitment and provider relation needs in order to fulfill the organization’s healthcare mission.

Risk Management (10%)

• Align medical service processes with applicable case law and changes in the regulatory environment in order to protect the organization, practitioners/providers, and the public.

• Monitor practitioner/provider performance continuously by developing and implementing policies that include the use of peer review data and processes in order to ensure uniformity, fairness, and quality of patient care.

• Facilitate due process in accordance with the organization’s fair hearing and appeals policy as well as legal and regulatory requirements in order to ensure uniformity and fairness.

Information Management (9%)

• Establish policy governing the management and distribution of information in accordance with accreditation, regulatory, and organizational requirements in order to serve the needs of stakeholders.

• Participate in the assessment, procurement, implementation, and maintenance of practitioner/provider information systems by communicating the needs of medical service functions in order to manage data with efficiency and integrity.

• Manage information as it pertains to medical services in accordance with confidentiality requirements in order to facilitate communication and protect stakeholders.