The UM Nurse Associate performs medical necessity review in response to requests for prior authorization of outpatient services. The UM Nurse Associate may also receive incoming calls from Providers submitting requests for prior authorization of services, and make outbound calls to providers as necessary. Utilizes clinical skills to support coordination, documentation and communication of medical services and/or benefit administration. Collects information to support the process of rendering appropriate medical necessity/benefit and determinations. Identifies members for referral opportunities to integrate with other products, services and/or programs Utilizes clinical experience, criteria/guidelines, policies and procedures in support of making timely and accurate medical necessity/benefit determinations.