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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 wins
Notes: Culture Fit
IDD/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 Depth
Analytical/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 decisions
Notes: Analytical/Intellectual HP
Leadership 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 opportunities
Notes: Leadership and EQ
Operations 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&L
What is your level of energy around hiring this candidate?
*
One
Two
Three
Four
Notes: Level of Energy Around Hiring
Final Thoughts/Recommendations
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