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 BelayNotes: Culture FitLeading 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 actionNotes: Leading Through InfluenceNetwork Building One - Below Average Two - Average Three - Above Average Four - Exceptional Experience building and leading a network of Physician Practices Notes: Network BuildingDrive/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 forwardNotes: Drive/AmbitionVBC Knowledge One - Below Average Two - Average Three - Above Average Four - Exceptional Subject Matter Expertise within Value Based Care constructs and conceptsNotes: VBC KnowledgeWhat is your level of energy around hiring this candidate?* One Two Three Four Notes: Level of Energy Around HiringFinal Thoughts/Recommendations
