WORKING IN A MILITARY ENVIRONMENT

1. WORKING IN A MILITARY ENVIRONMENT Randy Carey-Walden, RN, BSN, MS Illinois Army National Guard Case Manager Contractor 217.761.3561 randy.walden@us.army.mil

2. What is Case Management? Case management is defined by the Case Management Society of America (CMSA) as "....a collaborative process which assesses, plans, implements, coordinates, monitors and evaluates options and services to meet an individual’s health needs using communication and available resources to promote quality, cost effective outcomes." This is further defined by our contract and your individual SOW (Statement of Work).

4. A Little History Case management as a process began post-World War II in 1945. Military wounded were sent home with devastating injuries that required complicated medical care and rehabilitation for reentry into civilian life. Magnifying this need were the advances in medical technology. The term "case management" first appeared in social work and nursing literature in the 1960’s.

5. Military Case Management • Soon the military branches began to see a need for case management. • The military and civilian healthcare sectors were now working hand in hand with civilian HMOs. • The military health system had never been exposed to terms such as "preauthorization," "covered benefits,” "network and non-network providers,” "Memorandums of Understanding," etc. • Cost containment had never been an issue. This all changed in 1994.

6. Teamwork Teamwork is a lot of people doing what I say

7. Effective Team Players • Demonstrate reliability • Communicate constructively • Listen actively • Function as an active participant • Share openly and willingly • Cooperate—pitch in to help • Exhibit flexibility • Show commitment to the team • Work as a problem solver • Treat others respectfully and supportively

8. Tips for Playing Well with Others • Make the best of it. We spend more hours with co-workers than with any other group of people • Teamwork is not only necessary—we cannot do this job without it • People come from varying backgrounds, levels of education, ethnic groups, etc. • Making the most of your time at work can mean the difference between loving your job and rewriting your resume

9. Check your Attitude

10. You’re in the Army now! • Working with the military is rewarding and exciting, but it is not the same as a civilian medical environment • You’re not in a democracy. Orders are issued at different levels and we follow orders just as Soldiers do • We all contribute to the Individual Medical Readiness (IMR) of the Army National Guard (ARNG) but we are here to meet their goals—not our own • Your input is often sought, but our duties are driven by our contract and by army regulations

11. Civilians & the Military • 40% of army personnel resources are now civilian positions but this is still a military operation • Positive military-civilian working relationships are critical to success • Productivity is adversely affected if working relationships are poor—this is true in any work place

12. Regulations • Army regulations are the policies and procedures of the military • Army regulations cover nearly every aspect of military operations • Change is effected, but only within regulations

13. Learn to think outside the circle too!

14. Basic Tips for Success • Heads up! • Listen! • Show interest! • Be a mentor! • Assume the best! • Share credit when due!

15. Basic Tips for Success • You might be wrong! • Honor commitments! • Be appreciative! • To BFF or not? • Don’t play the blame game!

16. Everyone is Good at Something

17. Basic Tips for Success • Go to a meeting prepared! • Body language speaks volumes! • Be helpful! • Don’t blind side!

18. Pay Attention—There Will be a Test Later • That test may be that you’re required to pull a report from MEDPROS or other systems. Learn, learn, learn. This is a complex position for most of us. • I tell new staff in Illinois to give themselves a year before they’re comfortable and don’t get frustrated. Ask questions and learn.

19. Questions?

20. More Tips • Be positive (negative attitudes are toxic) • Be friendly, supportive and cooperative • Be a responsible member of the team • Be considerate of others • Focus on coworker’s good points • Don’t discuss personal issues if you don’t want it repeated • Make the best of any situation • Seek assistance when needed

21. More Tips • Be complimentary to others when they’re deserving • Be proud but don’t brag • Recognize that each person has a unique personality • Communicate in a relaxed and patient manner • Plan what you want to say beforehand • Be straight forward but not rude • Don’t put people on the defensive • Make sure you understand what was said • Allow everyone to speak or make suggestions • Private criticism, public praise

22. Be Proud—Don’t Brag

23. The Case Management Team • 54 different armies: Every state will do things a little differently • MCCs are supervised by case managers • Case managers will report to the military person in the respective state, usually the HSS and DSS

24. The ILARNG as an Example • MCCs report to the case manager that works with a specific brigade (5 in Illinois) • All Case Managers (and ultimately the MCCs) report to me • All travel requests, timesheets, etc. go through me so that Sterling is not flooded with individual emails • I act as the POC for the contract and try to answer questions and deal with situations so that Sterling can concentrate on other areas. Most questions can be answered locally • I report to the HSS and DSS

25. If there is a question about what duties a contracted civilian on the MCM Contract can perform, the military defers to me: Example: The full time LOD (Line of Duty) NCO needed assistance. Our contract specifically forbids work on LODs and we could not provide administrative support in this area Example: Illinois’ military archives contained medical documentation inappropriately mixed with personnel documents. They requested temporary help removing medical documentation from these records and filing them correctly in the medical record. This is an appropriate use of our personnel and administrative support was granted.

26. Questions?

27. Go Forth & Conquer Learn what you can while you’re here Don’t get frustrated…it will get better and easier Take notes and go back to your states and ask questions Network with your peers here annually—they usually have good ideas or have already solved a problem you’re facing!

28. Thanks for your time! Randy Carey-Walden, RN, BSN, MS Case Manager Contractor Illinois Army National Guard Medical Support-Joint Force Headquarters 217.761.3561 randy.walden@us.army.mil