Tiersa has been the “Acting Director” over CRC for almost two years. During this time, a new system was being implemented to help beneficiaries access the medical field more efficiently: the Integrated Referral Management and Appointing Center (IRMAC). This system required all the facilities involved to pool their resources and patients, creating a more direct path to navigate the healthcare system.

Since this approach was new, its implementation was largely left to each director’s interpretation. Tiersa came into the office and took the bull by the horns. She trained the Referral Managers on how to efficiently use available resources, resulting in patients seeing the specialists they needed in significantly less time—despite each of the five facilities having different referral processes and provider workflows.

Tiersa created a Capability Report outlining what each facility could handle. She then developed a standardized referral process, complete with a training kit, so that all staff could work as one team—speaking the same language, following the same actions, and driving consistent outcomes. Productivity increased, and at the forefront of it all was Tiersa’s commitment to getting soldiers and their families the care they needed.

This shift increased the workload for referral managers and support staff, essentially turning their world upside down. But Tiersa anticipated this. She often took on the workload herself to help the team meet the demand. At our peak, CRC was processing over 18,000 referrals a month!

To reduce stress, she created a break room—stocked with coffee, ice machines, microwaves, a fridge, tables, chairs, and healthy snacks—all paid for out of her own pocket. She never asked for anything in return. She encouraged breaks, made sure we took our lunches, and got to know each of us personally. She gave us respect, and in return, we gave it right back. She created a team.

The office was decorated seasonally, holidays were celebrated, and additional break stations appeared—all funded by Tiersa in a department that had no budget. She made us feel seen and valued. And others noticed.

IRMAC leadership saw our progress. Provider utilization was up. Referral volume increased. Time to care decreased. The result? Millions in savings for DHA. Tiersa was recognized as one of only two leaders in the U.S. who had successfully built a true IRMAC Team.

All of this while completing her doctorate degree.

Following successful inspections, Tiersa was awarded 16 more MTFs, 15 more staff members (more than doubling the current team), and promises of continued expansion. The challenge? There was no budget for desks, chairs, or file cabinets. The office space and computers would be provided, but to comply with ADA regulations, new desks were needed.

Tiersa, again without complaint, purchased seven sit-to-stand desks herself so her team could be comfortable and compliant. She stayed late to move computers and set up the offices—so when staff returned, they could start work with zero downtime.

Tiersa is the most intelligent, dedicated, fair, respectful, and compassionate leader I’ve ever seen. She works weekends to ensure everything is in place for us. She’s done every job in the referral process, and she’s never above jumping in when needed. To her, we all matter—and we all love her for it.

Back to her original goal: helping soldiers. Based on measurable outcomes—cost savings, efficiency, and improved access to care—Tiersa has absolutely made a difference.