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On Belay RVP-Network Management Feedback Form
On Belay RVP-VBC Network Management Interview Feedback Form
Date of Interview
*
Month
Day
Year
Name: Interviewer
First
Last
Name: Candidate
First
Last
Culture Fit to on Belay
One - Below Average
Two - Average
Three - Above Average
Four - Exceptional
Confidence that they will integrate into and enhance the culture of On Belay
Notes: Culture Fit
Leading Through Influence
One - Below Average
Two - Average
Three - Above Average
Four - Exceptional
Confidence in this person's ability to lead without authority, to create a compelling roadmap and gain consensus from stakeholders and have them commit to action
Notes: Leading Through Influence
Network Building
One - Below Average
Two - Average
Three - Above Average
Four - Exceptional
Experience building and leading a network of Physician Practices
Notes: Network Building
Drive/Ambition
One - Below Average
Two - Average
Three - Above Average
Four - Exceptional
Demonstrated capacity for continued growth and advancement of their own executive skills and an innate will to win that keeps them pushing forward
Notes: Drive/Ambition
VBC Knowledge
One - Below Average
Two - Average
Three - Above Average
Four - Exceptional
Subject Matter Expertise within Value Based Care constructs and concepts
Notes: VBC Knowledge
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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