Patient Coordinator 90-Day Review

Tier competency check, KPI evaluation, and 90-day performance feedback for new PCs.

Employee Information

PC Name

Home Office

Current Pay Rate

Current Tier

Hire Date

Review Date

Reviewer Name

Review Period

Score Scale: 0 – Not Observed 1 – Below Expectations 2 – Developing 3 – Meets Expectations 4 – Exceeds Expectations 5 – Outstanding

Part 1 — KPI Performance (8 metrics)

KPI	Target	Score

Part 2 — Performance Categories (6 areas)

Category	Score

Score Summary — out of 70 points

Part 1 · KPI

—/40

Part 2 · Performance

—/30

Total

—/70

—

Feedback & Development Notes

Key Strengths

Areas for Improvement

90-Day Goals & Action Items

Compensation Override (Optional)

Apply a manual rate override for this review

New Rate ($/hr)

Effective Date

Override Reason / Notes

Recommendation

Advance to next tier at next eligible date Stay at current tier — continue development Performance improvement plan required

Signatures & Submission

Employee Signature

Reviewer Signature *

Review Date

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