Interview Assessment Form
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Characteristic or Attribute
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Y/N
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Need more info
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Motivated to work with others, especially beneficiaries
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Has good people skills
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Has an ability to listen
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Has counseling experience
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Could speak in public about SHIP
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Knows computers
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Understands the Medicare and Medicaid programs
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Has experience working with seniors
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Has experience working with people with disabilities
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Could help SHIP reach out to new types of beneficiaries
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Has experience working in health care field
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Has experience working with large bureaucracies
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Has experience in trouble-shooting and problem-solving for others
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Has an ability to explain complex information in simple terms
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Has an ability to write clearly
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I am excited about this candidate because:
I have the following concerns about this candidate:
This person would be a good candidate to help SHIP with (circle below):
Medicare Counseling
Program Support
Community Outreach
Other
This person can provide _______ hours per week.
This person can participate in our next orientation session on _____________________________.
This person needs training about Medicare/Medicaid on _________________________________.
