Porter Senior Clinical Credentialer at Porter managing end-to-end credentialing and recredentialing for healthcare providers. Ensures compliance with credentialing, licensing, regulatory, and documentation requirements.
Responsibilities
Own and manage the full lifecycle of clinical credentialing for Porter’s clinical workforce.
Verify provider qualifications, including licenses, certifications, education, training, work history, malpractice coverage, and other required credentials.
Conduct primary source verification and maintain accurate, complete, and audit-ready provider credentialing files.
Manage credentialing requirements for Nurse Practitioners, Registered Nurses, Licensed Practical Nurses, and other clinical professionals.
Monitor provider licenses, certifications, registrations, malpractice insurance, and other time-sensitive credentials to ensure compliance with applicable requirements.
Proactively track expirables and initiate renewal processes well in advance of expiration dates.
Identify and resolve credentialing discrepancies, gaps, and compliance issues, escalating concerns when appropriate.
Coordinate provider enrollment and credentialing activities with health plans, payers, healthcare organizations, and other external partners as needed.
Guide clinical providers through credentialing, onboarding, and related compliance requirements, serving as a knowledgeable resource throughout the process.
Partner with Clinical Operations, HR, Compliance, and leadership to ensure providers are appropriately credentialed and cleared before providing patient care.
Maintain accurate provider information and credentialing documentation within internal systems and databases.
Develop, document, and continuously improve credentialing workflows, processes, checklists, and standard operating procedures.
Qualification
Required
7+ years of clinical credentialing experience, preferably within a healthcare organization, medical group, health plan, staffing organization, or similar environment.
Strong understanding of the provider credentialing and recredentialing lifecycle, including primary source verification and ongoing monitoring.
Experience credentialing a variety of healthcare professionals, including Nurse Practitioners, Registered Nurses, Licensed Practical Nurses, and other clinical providers.
Working knowledge of healthcare licensing, certifications, malpractice insurance, professional references, education verification, and other provider qualification requirements.
Experience working with payer or health plan credentialing and enrollment processes is strongly preferred.
Familiarity with credentialing databases, provider management systems, CAQH, and other healthcare credentialing platforms.
Strong understanding of healthcare compliance requirements and the ability to research and interpret credentialing, licensing standards and running system audits.
Exceptional attention to detail and accuracy, particularly when working with sensitive provider and compliance information.
Strong organizational and time-management skills with the ability to manage multiple providers, deadlines, and priorities simultaneously.
Excellent written and verbal communication skills with the ability to effectively communicate with clinicians, internal stakeholders, health plans, and external partners.
Demonstrated ability to identify problems, independently research solutions, and proactively resolve credentialing issues.
Comfortable working independently while also collaborating closely with Clinical Operations, HR, Compliance, and leadership.
