I work for a health insurance company and do clinical chart reviews to determine medical necessity. At the company I work for there are almost a thousand nurses that work across the country doing pre-certification, retrospective review and case management. Some work from home and others work in the office. It is great, no holidays or weekends and best of all nobody dies! The qualifications are usually at least two years of clinical but varied nursing experience is preferred. I have been working in the insurance industry for 15 years now.