Talley Anderson
Forney,TX
Summary
Dynamic healthcare leader with extensive experience at Heights Dermatology and Aesthetics, excelling in patient access coordination and prior authorization management. Proven track record in enhancing operational efficiency and compliance, while advocating for patients. Adept at cross-functional collaboration and conflict resolution, achieving a 99% approval rate in prior authorizations.
Overview
28
28
years of professional experience
Work History
North Texas Director & Biologic Team Supervisor
Heights Dermatology And Aesthetics
Dallas, TX
06.2020 - 11.2025
- Directed clinical and administrative operations across multiple sites within an assigned geographic region, ensuring alignment with organizational goals and compliance standards.
- Provided comprehensive clinical oversight and leadership to multidisciplinary teams, including healthcare providers, clinical staff, and administrative personnel.
- Managed daily operations of the biologics team, overseeing prior authorizations, patient access coordination, insurance compliance, and resolution of denials and appeals.
- Implemented and monitored policies, procedures, and performance metrics to drive operational efficiency, regulatory compliance, and high-quality patient care.
- Conducted regular site visits to evaluate performance, identify improvement opportunities, and provide training, coaching, and operational support.
- Collaborated with field access teams through weekly meetings to streamline workflows, enhance communication, and optimize patient care delivery.
- Provided strategic oversight for biologic access programs across 24 offices and 32 providers throughout Texas and North Carolina, ensuring timely patient access to high-cost specialty therapies.
- Directed daily operations and workflow for the biologic coordination team, driving efficiency and excellence in patient care delivery.
- Supervised, trained, and mentored biologic coordinators and support staff, fostering professional growth and accountability.
- Conducted performance evaluations across multiple sites, maintaining consistency in standards, compliance, and patient satisfaction.
- Collaborated with cross-functional departments to develop, implement, and enforce company policies and clinical best practices.
- Oversaw end-to-end prior authorization operations, including new starts, renewals, re-certifications, and appeals, achieving a 99% approval rate and 100% overturn success on appeals.
- Managed 15,000+ biologic patients annually, coordinating access and reimbursement with payers, specialty pharmacies, and pharmaceutical partners.
- Partnered with insurance carriers and reimbursement specialists to resolve complex access barriers and expedite patient therapy starts.
- Streamlined PA workflows using alternative access methods beyond CoverMyMeds, reducing turnaround times and improving patient adherence.
- Led initiatives to reduce therapy gaps through improved patient tracking, follow-up systems, and adherence monitoring.
- Conducted regular audits of biologic documentation, billing, and charting to ensure accuracy and adherence to payer and regulatory standards.
- Reviewed provider documentation for correct coding, charge capture, and clinical completeness prior to billing submission.
- Maintained full compliance with HIPAA, PHI, and company confidentiality policies, ensuring patient safety and data security.
- Designed and implemented standardized policies and audit tools to sustain compliance across all clinical sites.
- Served as the Access Training Lead company-wide, delivering ongoing training and policy updates to providers and clinic staff on coverage criteria, PA processes, and payer requirements.
- Conducted virtual and in-person presentations (Zoom, Teams, GoTo) for clinical and administrative staff to ensure consistent understanding of biologic access protocols.
- Partnered with HUB programs, infusion centers, specialty pharmacies, and pharmaceutical manufacturers to ensure transparent communication and alignment on patient support services.
- Represented the organization in cross-functional and manufacturer-led meetings to advocate for provider and patient needs.
- Subject-matter expert in payer policy, medical/pharmacy benefits, and reimbursement pathways across Commercial, Medicare, Medicaid, VA/DOD, Tricare, and ACA plans.
- Proficient in interpreting step therapy requirements, Senate Bill 680 provisions, and peer-to-peer review protocols to secure access for patients.
- Collaborated with manufacturers and market access teams to navigate reimbursement challenges and implement compliant access solutions.
- Utilized data analytics to identify coverage trends and process improvements, optimizing patient access outcomes.
- Deep understanding of biologic and biosimilar therapies, including IL-17, IL-23, TNF inhibitors, IL-4/IL-13, monoclonal antibodies, and receptor alpha inhibitors, JAK inhibitors, Burton's tyrosine kinase inhibitors.
- Extensive knowledge of key biologic agents such as Rhapsido, Bimzelx, Humira (and bio sims such as Cyltezo, Hyrimoz, Simlandi, Yuflyma), Nemluvio, Rituxan, Rinvoq, Cibinqo, Litfulo, Enbrel, Remicade, Dupixent, Rinvoq, Xeljanz, Inflectra, Skyrizi, Cosentyx, Taltz, Tremfya, Otezla, and Stelara (and related biosimilars), Cimzia, Siliq, Avsola, Simponi Aria, Odomzo, Libtayo, Aldara (and others similar), Sonidegib, Vismodegib, Keytruda, Unloxcyt, Yervoy, Opdivo, Bavencio, Zynyz, Ilumya, topical therapies such as Opzelura and Vtama, and many others.
- Experienced in lab monitoring, test interpretation, and patient education for chronic inflammatory, autoimmune, and oncologic conditions.
- Proven leadership and organizational acumen in high-volume, fast-paced healthcare environments.
- Exceptional problem-solving, communication, and relationship-building skills, fostering strong partnerships with providers, payers, and patients.
- Adept at simplifying complex coverage scenarios and implementing scalable solutions that improve patient outcomes and operational performance.
- Driven, detail-oriented, and results-focused professional with a strong commitment to patient advocacy and access equity.
- Directly interacted with clinical research participants for multiple research studies and clinical trials within all phases.
- Coordinated regulatory documentation for research studies that includes maintaining information to comply with industry standards, University policies, FDA requirements or other hospital policies.
- Followed subjects according to research protocol guidelines.
- Maintained and coordinated data collection information required for each study using data collection tools.
- Assisted in developing and implementing research studies, including writing clinical research protocols.
- Conducted research procedures according to the protocol.
- Monitored patient safety by reviewing records, ensuring appropriate reporting per protocol and HRPP standards.
- Coordinated data management and collection for national (larger/more complex) research studies or multiple research studies.
- Prepared protocols for Institutional Review Board (IRB) submission.
- Reviewed research study protocols to ensure feasibility requirements, including safety, laboratory testing and monitoring (phlebotomy and preparation of specimens, coordinated lab testing and delivery).
- Maintained required subject documentation for each study protocol (Abbvie, Bristol-Myers Squibb, Novartis, etc.).
Clinical and Biologics Team Lead
North Dallas Dermatology Associates
Dallas, TX
02.2018 - 06.2020
- Managed complex patient cases and coordinated with multiple healthcare providers and teams, providing a meticulous approach to ensure accuracy in documentation, insurance coverage, and patient follow-up.
- Advocated for patients particularly when navigating insurance issues or financial assistance program needs, especially during the pandemic when many patients lost insurance.
- Provided comprehensive clinical oversight and leadership to multidisciplinary teams, including healthcare providers, clinical staff, and administrative personnel.
- Managed daily operations of the biologics, overseeing prior authorizations, patient access coordination, insurance compliance, and resolution of denials and appeals.
- Provided expertise in medication management, patient education, co-pays, specialty pharmacy services, prior authorizations, appeals, provided access through the payor matrix, to quickly resolve issues with obtaining and maintaining access to therapies.
- Maintained multiple patient cases simultaneously while collaborating with healthcare providers specializing in rare dermatological diseases.
- Ensured patients received timely biologic therapies and support while efficiently coordinating across medical and pharmacy teams.
- Collaborated with field access teams to identify potential issues, resolve access gaps, streamline workflows, enhance communication, and optimize patient care delivery.
- Provided resources and resolution for adequate patient care during the COVID-19 pandemic, requiring creative teamwork between clinical staff and providers.
- Proper planning, training and support was provided for providers to improve resources to provide safe patient care through telehealth visits.
- Defined protocols and implementation of processes allowing human resources to be utilized in a safe and effective manner to meet the demands of patient care needs in patients with chronic rare skin diseases.
COO/Clinical Director/ Biologic Team Manager
Adagio Dermatology
Tyler, TX
11.2015 - 02.2018
- Enhanced surgical prep efficiency by implementing a new scheduling system, reducing patient wait times by 90% within 3 months.
- Established a feedback loop with patients and providers, leading to improved service satisfaction and operational efficiency without relying on metrics.
- Led recruitment and training initiatives for clinical staff, achieving a 98% reduction in onboarding time within 6 months, enhancing overall team performance.
- Fostered a culture of continuous improvement by collaborating with staff on operational enhancements, significantly elevating patient care standards.
- Facilitated pre/post-surgery preparations and assisted in every surgical procedure, ensuring a seamless patient experience and maintaining high standards of care.
- Resolved access and reimbursement issues for all biologic patients within 6 months, enhancing patient access to biologic therapies through effective collaboration with HUBs, field access and reimbursement managers and specialty pharmacies.
- Educated biologic coordinators, staff, providers, and patients on enrollment and access processes, improving medication access by 100% within 3 months through targeted training sessions.
- Streamlined the biologic support process, significantly reducing barriers to medication access and improving patient satisfaction through effective communication and training.
- Supervised the executive team, providing guidance on operational decisions.
- Assisted in budgeting process by evaluating costs and allocating resources appropriately.
- Implemented innovative solutions to improve overall productivity levels within the organization.
- Built relationships with industry leaders both internally and externally to create new opportunities for growth.
- Analyzed market trends and assessed potential impact on organization's growth strategy.
- Negotiated contracts with vendors and suppliers to reduce costs while maintaining quality standards.
- Established plans to address productivity, operational performance and staff retention and satisfaction.
- Developed and refined short- and long-term strategies to drive growth and profitability.
- Conducted financial forecasting to explore strategic options and develop creative solutions to complex business issues.
- Chaired meetings to discuss strategic initiatives and operational issues.
- Oversaw corrective action plans to remedy structural, organizational and departmental issues.
- Exceeded sales goals through upselling and cross-selling within existing client base as well as strategically attracting new business.
- Optimized supply chain to reduce materials costs and improve distribution.
- Maintained relationships with external vendors to ensure adequate supplies were available.
- Maintained awareness of government regulations, health insurance changes and financing options.
Clinical Supervisor/Biologic and Surgical Lead
U.S. Dermatology Partners
Tyler, Lindale, Athens, Longview, Marshall, TX
10.2009 - 11.2015
- Ability to analyze, access/reimbursement issues, provide patients, HUBs, specialty pharmacies with access expertise.
- Well-skilled and possession of knowledge and intrapersonal skills to provide education to clinical staff, biologic coordinators and biologic-naive patients and continued education for the continuation of therapies by supporting each discipline throughout the process.
- Provided patient access support by resolving issues that often create barriers to medication/product access.
- Provided biologic support via insurance approvals, appeals, and support for field/payment/insurance reimbursement and injection support and training.
- Incredible knowledge of Centricity, NextGen, and EMA.
- Responsible for scribing and transcription of every patient visit, including but not limited to basic visits, full skin checks, MOHS and surgery.
- Mentor and support new staff.
- Performed surgical set-ups, provided direct patient care during each procedure or surgical operation, including taking tissue for MOHS, preparing slides and suturing or repairing of skin cancer sites.
- Provided chart audits for providers to ensure compliance with documentation requirements to minimize barriers and prevent patients from delays in accessing necessary and adequate treatment of prescribed biological treatments.
- Implemented quality assurance measures to maintain high standards of care.
- Facilitated staff meetings to discuss performance, challenges, and solutions.
- Created and implemented improvement plans to resolve issues and drive improvements to deficient areas.
- Developed and managed the clinical department budget, optimizing resource allocation for maximum efficiency.
- Coordinated with external stakeholders, including insurance providers and referral sources, to optimize patient services.
- Collaborated with dermatologists to enhance treatment protocols and patient outcomes.
Exec Director of Ops to Chief of Surgery
Trinity Mother Frances Hospital
Tyler, TX
10.2003 - 10.2009
- Provided a combination of clinical and administrative tasks, which included surgical scheduling time for the OR, obtaining medical clearance and arranging pre-and post-operative care.
- Obtained insurance verification and authorization for each surgery.
- Directly assisted in surgery, major and minor surgical procedures, provided exposure, passing of instruments, set up and maintained a sterile field.
- Assisted with closures, biopsies, and other intraoperative procedures, oversaw surgical staff, and managed administrative functions like clinic scheduling, budget requests, and policy implementation.
- Served as a liaison with other departments, assisting with staff and resident recruitment and evaluation, and representing the Chief on various committees.
- Implemented policies and professional standards for the surgical program, which includes inpatient wards, clinics, operating rooms, and recovery areas.
- Biologic coordination and oversight provided to neighboring team of clinicians (Gastroenterologists and Hematologist). Provided patient education for GI diseases such as inflammatory bowel diseases (IBDs)-ulcerative colitis (UC) and Crohn's disease (CD).
- Obtained access to biologic therapies for chronic immune-mediated disorders that often require long-term use of biologics and/or small molecules to achieve sustained disease remission.
- Streamlined access to infusion biologics such as infliximab by authorizing treatment orders, securing insurance approvals, and coordinating medication logistics to infusion and ambulatory care facilities.
- Facilitated prior authorizations and buy-and-bill processing for in-clinic administration of Stelara.
- Expanded patient access to advanced immunologic and biologic therapies for liver disease (e.g., HepaGam B, interferon, rituximab, infliximab, adalimumab, MMF, azathioprine, and belimumab), achieving an >80% increase in therapy availability within three months through optimization of medical and pharmacy benefit pathways.
- Coordinated communication between physicians and other healthcare providers.
- Contributed innovative ideas and solutions to enhance team performance and outcomes.
- Worked with cross-functional teams to achieve goals.
- Negotiated terms with vendors to secure favorable agreements for the organization.
- Managed contract lifecycle from initiation through execution and renewal processes.
- Developed standard operating procedures for efficient contract processing workflows.
- Developed contractual agreements, including terms and conditions, in accordance with established policies and procedures.
- Negotiated contracts with suppliers to obtain best value for goods and services.
- Assisted in the preparation of bid packages by researching market prices, identifying potential sources, evaluating bids received, and recommending awards.
- Provided guidance on contractual matters to internal stakeholders.
- Reviewed invoices submitted by contractors and vendors prior to payment authorization.
Clinical Supervisor, Radiology Tech, Osteoporosis & Diabetic Educator
Dailey Medical Clinics, LLC
Canton, TX
05.2000 - 02.2003
- Served as executive assistant and clinical operations director to the CEO/Physician, providing comprehensive management support across administrative, clinical, and business functions to ensure seamless practice operations.
- Directed recruitment, interviewing, onboarding, training, and performance management for clinical and administrative staff, including nurses, medical assistants, and front-office personnel.
- Oversaw day-to-day clinical operations, scheduling, and staffing to maintain optimal coverage and efficient patient flow across the practice.
- Ensured full OSHA and HIPAA compliance by implementing, monitoring, and training staff on safety and privacy protocols.
- Managed the prior authorization process for high-cost and specialty medications, achieving a 100% success rate through strategic payer communication and policy adherence.
- Collaborated with providers and staff to enhance patient access, streamline workflows, and improve operational efficiency across clinical and administrative departments.
- Supervised clinical functions including patient intake, vitals, phlebotomy, IV starts, scribing, and assistance with in-office procedures such as biopsies, cryotherapy, wound care, injections, EKGs, and immunizations.
- Supported provider services in specialized areas including OB/GYN, allergy testing and mixing, diabetes management education, radiology, bone density scans, orthopedics, cardiology and preventive care initiatives.
- Provided patient education and counseling on chronic disease management, treatment plans, and medication adherence to promote improved health outcomes.
Operational Director/Clinical Coordinator
University of Texas Woman's Healthcare/OB/GYN
Quitman, TX
06.1997 - 05.2000
- Oversaw personnel management functions such as recruiting, onboarding, training and staff development , performance evaluations, corrective actions, and employee retention initiatives.
- Ensured all clinical and administrative staff maintained current licenses, certifications, and ongoing education requirements.
- Collaborated with clinicians to develop and implement policies that improved patient outcomes, staff efficiency, and operational effectiveness.
- Problem-solved to address patient complaints, resolve issues, and manage facility maintenance.
- New clinical start-up and set-up, oversaw daily operations by managing staff, ensuring correct billing procedures, operations of the clinic from the ground up, budgeting and finances, ensuring compliance, and driving patient experience.
- Implemented strategic planning/clinic design, wrote policies, managed budgets, revenue cycle processes, and collaborated with physicians and staff to meet organizational goals for quality care, access, and financial performance.
- Provide guidance and support for patient care plans, including all aspects of helping women through their pregnancies and maintain optimal health, from puberty through menopause.
- Navigated comprehensive care for women's high-risk obstetrics, minimally invasive surgical procedures, infertility evaluations and complete gynecological care, potentially including specific services like IVF or postpartum care.
- Stayed current with best practices in women's health to drive quality improvement initiatives.
- Assisted where needed with patient triage, patient education, or case management, depending on the specific role versus need each day.
- Provided support and act as a resource for providers on clinical protocols and documentation.
- Handled communication with patients, other medical personnel, and outside entities.
- Ensured effective communication plans are in place for clinical operations as well as community and hospital involvement.
- Provided support and assistance with patients obtaining high-dollar specialty drugs used for more complex conditions such as cancer treatments, autoimmune conditions, neurological conditions, migraine prevention, infertility treatment drugs, and hormonal and non-hormonal therapies.
- Provided support, education and advocacy services to women in order to obtain therapies that may otherwise have negative consequences for women's health and their families.
- Developed strategic plans to align departmental goals with organizational mission.
- Directed the development and implementation of operational policies and procedures.
- Delivered organizational leadership and established strategic plans to advance organizational mission and promote profitability.
- Drafted reports and led presentations to inform upper management of operational inefficiencies and recommended improvements.
- Analyzed claim records, policy provisions, and other relevant documents to determine validity of claims.
Education
Ph.D. - Human and Biological Sciences
University of Texas
Dallas, TX12-2023
Master of Science - Human Sciences
Texas Tech University
Bachelor of Science - Biomedical Pre-Professionals
The University of Texas - Tyler
Bachelor of Science - Radiology
The University of Texas - Tyler
Associates of Applied Science -
Tyler Junior College
Skills
- Patient access coordination
- Prior authorization management
- Biologics expertise
- Regulatory compliance
- Clinical oversight
- Healthcare operations
- Cross-functional collaboration
- Logistics management
- Process improvement
- Stakeholder engagement
- Conflict resolution
- Operations management
- Contract negotiation
- Organizational development
- Biologic therapy coordination
- Patient advocacy
- Compliance auditing
- Policy implementation
- Formularies
- HIPAA compliance
Timeline
North Texas Director & Biologic Team Supervisor
Heights Dermatology And Aesthetics
06.2020 - 11.2025
Clinical and Biologics Team Lead
North Dallas Dermatology Associates
02.2018 - 06.2020
COO/Clinical Director/ Biologic Team Manager
Adagio Dermatology
11.2015 - 02.2018
Clinical Supervisor/Biologic and Surgical Lead
U.S. Dermatology Partners
10.2009 - 11.2015
Exec Director of Ops to Chief of Surgery
Trinity Mother Frances Hospital
10.2003 - 10.2009
Clinical Supervisor, Radiology Tech, Osteoporosis & Diabetic Educator
Dailey Medical Clinics, LLC
05.2000 - 02.2003
Operational Director/Clinical Coordinator
University of Texas Woman's Healthcare/OB/GYN
06.1997 - 05.2000
Ph.D. - Human and Biological Sciences
University of Texas
Master of Science - Human Sciences
Texas Tech University
Bachelor of Science - Biomedical Pre-Professionals
The University of Texas - Tyler
Bachelor of Science - Radiology
The University of Texas - Tyler
Associates of Applied Science -
Tyler Junior College