What you will do: 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.