Customer Success Workforce Planning and Performance Specialist

About the Company 

Antidote Health is a tech-driven health insurance company on a mission to make healthcare easy, accessible, and more affordable. We’re rethinking how healthcare works—using technology to remove the friction, complexity, and delays that define the traditional system. Instead of navigating paperwork, long waits, and disconnected experiences, we’re building a simpler, more connected way for people to get care.  

Our platform combines health coverage, virtual care, and a modern member experience into one seamless system designed to help people actually use their benefits.  

We offer Affordable Care Act (ACA) health plans in Arizona and Ohio, and we’re growing quickly. We’re building a company focused on solving real problems—with real impact on people’s lives.

Position Overview

The Customer Success Workforce Planning and Performance Specialist ensures that Antidote Health has the right trained and authorized employees available at the right times to support members, brokers, providers, patients, and internal partners. The position converts demand patterns, operational priorities, employee availability, and service goals into practical forecasts, capacity plans, schedules, and intraday recommendations.

This role owns assigned workforce-management processes across Tier 1 Member Services, Tier 2 Customer Success Operations, and Tier 3 Customer Advocacy and Regulatory Affairs. The Specialist partners with Operations, Training, Quality, Analytics, Human Resources, Compliance, and Technology to balance member access, regulatory obligations, workload health, schedule fairness, employee experience, and responsible use of company resources.

The Specialist provides analysis and recommendations; operational leaders retain accountability for employee coaching, attendance, performance management, and approval of material service or staffing tradeoffs. Success requires strong forecasting and analytical judgment, disciplined system administration, clear communication, and an understanding of both arrival-driven contacts and deadline-based healthcare casework.

Antidote Health's mission is to redefine healthcare by providing affordable, high-quality, accessible care and insurance products. The Customer Success organization supports that mission by making healthcare easier to understand, easier to access, and easier to navigate for members, brokers, patients, providers, and internal partners.

Key Responsibilities

• Develop and maintain interval, daily, weekly, monthly, seasonal, and annual demand forecasts for voice, chat, email, outbound, and case-based work.

• Use appropriate methods for each workload, including queueing or Erlang-based analysis for arrival-driven contacts and backlog, aging, due-date, and productivity models for casework and other back-office work.

• Incorporate historical volume, handle or processing time, shrinkage, channel mix, service goals, marketing activity, product changes, enrollment cycles, regulatory deadlines, holidays, and known business events.

• Measure forecast accuracy and bias at agreed levels of detail, explain material variance, and update assumptions and models when operating conditions change.

• Maintain documented assumptions, version history, data sources, and decision records for workforce plans.

• Translate demand forecasts into staffing requirements by channel, queue, tier, skill, language, location, and time period.

• Model productive capacity using staffing levels, skills, schedules, shrinkage, occupancy guardrails, planned training, leave assumptions, and expected productivity.

• Identify capacity gaps, surpluses, overtime exposure, backlog risk, and skill constraints, and present options with service, cost, compliance, and employee-experience tradeoffs.

• Support hiring, cross-training, vendor, schedule, and budget planning with documented scenarios and recommendations.

• Maintain short-range and long-range workforce plans and reconcile material differences between approved plans and actual staffing.

• Build, publish, and maintain schedules that align demand, employee skills, labor requirements, approved availability, and business priorities.

• Administer schedule bids, shift changes, time-off allocations, training blocks, meetings, offline work, overtime opportunities, and other workforce events under approved policies.

• Apply scheduling rules consistently and surface fairness, coverage, fatigue, or employee-experience concerns to the appropriate decision-maker.

• Coordinate with Training and Operations so employees assigned to specialized or regulated work are trained, certified, authorized, and, where applicable, appropriately licensed.

• Maintain schedule and staffing data accurately in the workforce-management platform and connected operational systems.

• Monitor intraday demand, staffing, adherence, backlog, aging, service levels, response times, and other agreed operational indicators.

• Identify deviations from plan, determine likely causes, and recommend actions such as reforecasting, skill movement, schedule adjustments, voluntary overtime, offline-work deferral, or contingency activation.

• Follow an approved intraday decision framework that defines which actions the Specialist may execute, which require Operations approval, and how urgent risks are escalated.

• Communicate intraday conditions and decisions clearly to operational leaders and affected partners without assuming responsibility for employee coaching or performance management.

• Maintain handoff and backup procedures so real-time coverage does not depend on one employee or one shift.

• Lead workforce planning support for Open Enrollment, product launches, regulatory changes, system implementations, weather events, outages, and other predictable or emerging demand events.

• Create readiness scenarios, staffing plans, escalation thresholds, and recovery plans in partnership with Operations and cross-functional stakeholders.

• Track actual results against readiness assumptions and document lessons for future planning cycles.

• Support business-continuity exercises and workforce recovery planning for significant disruptions.

• Administer assigned workforce-management platform configurations, forecasts, schedules, skills, user access, business rules, and reporting components within approved governance.

• Partner with Technology, Security, vendors, and designated system owners on integrations, releases, defects, access controls, and changes outside delegated administrative authority.

• Validate data feeds and reconcile workforce data across Five9, CRM, case-management, payroll, HR, learning, and reporting systems as applicable.

• Document configuration, changes, testing, issue resolution, and continuity procedures, and protect PHI, employee data, and other confidential information.

• Identify automation opportunities while preserving review, control, and auditability for consequential workforce decisions.

• Produce accurate workforce reporting for forecasts, staffing, capacity, schedules, adherence, shrinkage, occupancy, backlog, productivity, overtime, and service performance.

• Analyze variance and root causes and distinguish workforce drivers from process, training, technology, content, policy, demand, or performance issues.

• Present findings, risks, options, and recommendations to operational and executive audiences in clear business language.

• Partner with Analytics on metric definitions, data quality, dashboards, and deeper analysis while retaining ownership of workforce assumptions and interpretation.

• Track material recommendations through decision and, when adopted, evaluate whether they produced the intended outcome.

Qualifications

Required

• Four or more years of workforce management, capacity planning, scheduling, operations analysis, or closely related experience in a contact center or service operation.

• At least two years of hands-on experience with a workforce-management platform, including forecasting, scheduling, intraday management, reporting, or platform administration.

• Experience supporting multichannel operations and both real-time contacts and deadline-based case or back-office work.

• Demonstrated ability to build forecasts and staffing models, analyze variance, explain assumptions, and recommend practical actions.

• Advanced spreadsheet skills and working knowledge of reporting, data visualization, or business-intelligence tools.

• Strong written and verbal communication skills, including the ability to explain workforce tradeoffs to operational leaders.

• Demonstrated discretion with employee, operational, and healthcare-related information and the ability to work across competing priorities.

• High school diploma, GED, or equivalent required.

Preferred

• Workforce-management experience in a health plan, healthcare contact center, telehealth organization, pharmacy, third-party administrator, or other regulated service environment.

• Experience with Five9 Workforce Optimization or another enterprise platform such as NICE, Verint, Calabrio, Genesys, or UKG.

• Experience with ACA Open Enrollment, member services, eligibility, benefits, claims, billing, prior authorization, appeals, grievances, or regulatory casework.

• Experience forecasting digital channels and modeling backlog, aging, due dates, and skill-based casework.

• Experience with SQL, Power BI, Tableau, Looker, or comparable analytical tools.

• Experience supporting platform implementations, integrations, configuration governance, or automated workforce processes.

• SWPP, ICMI, COPC, Lean Six Sigma, or comparable workforce or process-improvement training or certification.

• Associate or bachelor’s degree in business, operations, analytics, economics, mathematics, healthcare administration, or a related discipline preferred. Equivalent relevant experience is accepted in lieu of a degree.

Compensation and Benefits

• Base salary range: $75,000 - $95,000 (commensurate with experience and location)

• Comprehensive benefits package including medical, dental, vision

• 401(k)  

• Paid vacation and sick time and company holidays

Company Standards and Expectations

• Employment is at-will, meaning either the employee or the company may terminate employment at any time, with or without cause, in accordance with applicable law

• Employees are expected to adhere to all company policies, including confidentiality, data protection, and code of conduct

• Responsibilities may evolve based on business needs, and flexibility is expected as the company scales

• Compliance with all applicable federal, state, and local laws and regulations is required

Equal Opportunity Statement

Antidote Health is an equal opportunity employer and makes employment decisions without regard to race, color, religion, sex, national origin, age, disability, veteran status, or any other protected status under applicable law.