Case Management Nurse

About the Role

Virtus Health Services is expanding its Case Management and Care Coordination team to support members experience and enhance patient journey.

Key Responsibilities

• Review medical records, diagnostic reports, treatment plans, and clinical documentation to assess case severity, medical appropriateness, and recommended care pathways.
• Evaluate the medical necessity and cost-effectiveness of proposed investigations, treatments, surgeries, therapies, and rehabilitation services.
• Educate patients and caregivers on disease management, medication adherence, and lifestyle changes.
• Guide patients and their families through available treatment options within the healthcare provider network, ensuring timely access to appropriate specialists and medical facilities, including oncology, neurosurgery, cardiology, rehabilitation, and other relevant disciplines.
• Provide emotional support to patients
• Monitor patient progress during hospitalization and facilitate timely discharge planning.
• Evaluate medical necessity and cost-effectiveness of proposed treatments.
• Document all interactions with clients

Qualifications

• Registered Nurse (RN) with valid Hong Kong Nursing Council registration
• Minimum 5 years of clinical experience, preferably in chronic disease, rehabilitation, or acute care settings
• Prior experience in case management, care coordination, or insurance liaison is highly desirable
• Strong communication and documentation skills
• Familiarity with chronic care management protocols and patient-centered care principles
• Proficiency in English and Cantonese; Mandarin is a plus

What We Offer

• Supportive, multidisciplinary team environment.
• Opportunities for professional development and training.
• Meaningful work that improves patient outcomes and system efficiency.