Broadstep – Feedback Form Broadstep - Area/Executive Director Feedback Form Date of Interview* Month Day Year Name: Interviewer First Last Name: Candidate First Last Culture Fit One - Below Average Two - Average Three - Above Average Four - Exceptional Demonstrated humility and capacity for working within a complex and highly matrixed environment. Commitment to team winsNotes: Culture FitIDD/Behavioral Health Depth One - Below Average Two - Average Three - Above Average Four - Exceptional Experience working in IDD market segment within healthcare services and/or health plan Notes: IDD/Behavioral Health DepthAnalytical/Intellectual HP One - Below Average Two - Average Three - Above Average Four - Exceptional Quick study of complex clinical/operational puzzles with proven experience of using data and metrics to make business decisionsNotes: Analytical/Intellectual HPLeadership and EQ One - Below Average Two - Average Three - Above Average Four - Exceptional Proven ability to hire/train/develop team members in the midst of Broadstep's growth and evolving market opportunitiesNotes: Leadership and EQOperations and Budget/P&L Experience One - Below Average Two - Average Three - Above Average Four - Exceptional Experience leading diverse team in multi-site operations model and owning financial outcomes for a region Notes: Operations and Budget/P&LWhat is your level of energy around hiring this candidate?* One Two Three Four Notes: Level of Energy Around HiringFinal Thoughts/Recommendations
