How does Kaiser Permanente make decisions around promotions?

Very glacial. Not always meritocratic. Too many rules in place that govern the process by which promotions take place. Too often ,however, these rules are used to prevent promotions rather than to encourage them.

It's based on performance related to the current and next step up in the job family, and determined by the manager.

Manager proposes, HR and boss need to approve. When it's the exec level, the exec compensation board needs to approve.

It varies by department, team, and budget