Conduct medical necessity reviews—including inpatient, concurrent, benefit advisory/prior authorization, retrospective, out-of-network, and treatment-setting reviews—to ensure alignment with applicable clinical criteria, medical policies, member eligibility, benefits, and contracts. You will collaborate with Medical Directors and teams across Premera—including FEP, National Account Liaisons, Health Care Services, and Claims—to support appropriate, cost-effective care for members across all lines of business and geographic regions.