Healthcare Economist

Company Description

Antidote Health's mission is to redefine healthcare by providing affordable, high-quality, accessible care and insurance products. We believe in the fundamental human right to quality everyday healthcare and aims to create a world where no one is left behind.

Role Description

You are an experienced, mission-driven team member who can flex and adapt to the shifting circumstances of a growth-stage startup. You are responsible for market insights and benefit design, oversees actuarial and financial execution, and perform data dashboarding and analyses to enhance care quality, reduce costs, and improve health and financial outcomes of our members. This is a full-time hybrid role, located in New York, NY, reporting to the General Manager of the HMO.

Key Responsibilities

Market Insights & Benefit Design

• Analyze healthcare market dynamics, competitor offerings, and population health trends to inform product and benefit design.
• Provide insights into the demographics, behaviors, and risk profiles of populations we aim to attract and retain.
• Support strategic decisions on benefit design and pricing with evidence-based recommendations.

Actuarial & Financial Execution

• Partner with actuaries to evaluate pricing scenarios, risk adjustment factors, and financial sustainability of benefit designs.
• Perform cost modeling and utilization forecasting to anticipate financial impacts of product decisions.
• Support regulatory filings and actuarial certifications as needed.

Data Analytics

• Build and maintain robust data pipelines to integrate claims, enrollment, clinical, and external datasets.
• Develop statistical and econometric models to evaluate program performance, healthcare utilization, and policy changes.

Generate dashboards and reporting tools to translate complex data into actionable insights for executives and product leaders.

Qualifications & Skills

Required:

• Master’s or PhD in Health Economics, Public Policy, Actuarial Science, Biostatistics, Applied Economics, or a related field.
• 3–7 years of experience in health insurance, healthcare consulting, actuarial services, or related roles.
• Strong understanding of healthcare markets, benefit design, and risk adjustment mechanisms.
• Proficiency in data analysis tools such as SQL, Python.
• Experience with actuarial modeling and financial forecasting.
• Excellent communication skills, with the ability to translate technical findings into strategic business insights.

Preferred:

• Proficiency in working with health insurance operations, including enrollment, claims, and provider networks.
• Understanding of NCQA, HEDIS, and other healthcare quality metrics.
• Knowledge of healthcare compliance and data privacy regulations (HIPAA, CMS guidelines).
• Prior work in telehealth, digital health, or value-based care environments.
• Strong stakeholder communication and data storytelling skills to translate insights into business actions.