Molina Healthcare Capabilities

Naftiko 0.5 capability definitions for Molina Healthcare - 100 capabilities showing integration workflows and service orchestrations.

Sort

Expand

Azure DevOps Build Status ▼

devops azure-devops ci-cd

Checks the latest build status of a given pipeline in Azure DevOps, returning build number, result, and completion time.

naftiko: "0.5"
info:
  label: "Azure DevOps Build Status"
  description: "Checks the latest build status of a given pipeline in Azure DevOps, returning build number, result, and completion time."
  tags:
    - devops
    - azure-devops
    - ci-cd
capability:
  exposes:
    - type: mcp
      namespace: ci-cd
      port: 8080
      tools:
        - name: get-build-status
          description: "Check the latest Azure DevOps build status for a pipeline. Returns build number, result, and finish time."
          inputParameters:
            - name: pipeline_id
              in: body
              type: string
              description: "The Azure DevOps pipeline definition ID."
          call: "azuredevops.get-builds"
          with:
            pipeline_id: "{{pipeline_id}}"
  consumes:
    - type: http
      namespace: azuredevops
      baseUri: "https://dev.azure.com/molina/MolinaHealthIT/_apis/build"
      authentication:
        type: basic
        username: "$secrets.azdo_user"
        password: "$secrets.azdo_pat"
      resources:
        - name: builds
          path: "/builds?definitions={{pipeline_id}}&$top=1&api-version=7.0"
          inputParameters:
            - name: pipeline_id
              in: query
          operations:
            - name: get-builds
              method: GET

Behavioral Health Coordination Pipeline ▼

behavioral-health care-coordination salesforce servicenow zoom microsoft-teams

Coordinates behavioral health services by pulling member clinical data from Salesforce, creating a care plan in ServiceNow, scheduling a telehealth session via Zoom, and notifying the behavioral health team via Microsoft Teams.

naftiko: "0.5"
info:
  label: "Behavioral Health Coordination Pipeline"
  description: "Coordinates behavioral health services by pulling member clinical data from Salesforce, creating a care plan in ServiceNow, scheduling a telehealth session via Zoom, and notifying the behavioral health team via Microsoft Teams."
  tags:
    - behavioral-health
    - care-coordination
    - salesforce
    - servicenow
    - zoom
    - microsoft-teams
capability:
  exposes:
    - type: mcp
      namespace: behavioral-health
      port: 8080
      tools:
        - name: coordinate-behavioral-health
          description: "Given a member ID and service type, create a care plan, schedule a telehealth session, and notify the team."
          inputParameters:
            - name: member_id
              in: body
              type: string
              description: "The Molina member ID."
            - name: service_type
              in: body
              type: string
              description: "The behavioral health service type."
            - name: preferred_date
              in: body
              type: string
              description: "Preferred appointment date in YYYY-MM-DD format."
          steps:
            - name: get-clinical-data
              type: call
              call: "salesforce.get-clinical-record"
              with:
                member_id: "{{member_id}}"
            - name: create-care-plan
              type: call
              call: "servicenow.create-incident"
              with:
                short_description: "Behavioral health care plan: {{member_id}}"
                category: "behavioral_health"
                description: "Service type: {{service_type}}. Diagnosis: {{get-clinical-data.Primary_Diagnosis__c}}."
            - name: schedule-telehealth
              type: call
              call: "zoom.create-meeting"
              with:
                topic: "Behavioral Health Session - {{member_id}}"
                start_time: "{{preferred_date}}T10:00:00Z"
                duration: "60"
            - name: notify-team
              type: call
              call: "msteams.post-message"
              with:
                team_id: "behavioral-health-team"
                channel_id: "care-plans"
                message: "New care plan {{create-care-plan.number}} for member {{member_id}}. Telehealth scheduled: {{schedule-telehealth.join_url}}."
  consumes:
    - type: http
      namespace: salesforce
      baseUri: "https://molina.my.salesforce.com/services/data/v58.0"
      authentication:
        type: bearer
        token: "$secrets.salesforce_token"
      resources:
        - name: clinical-records
          path: "/query/?q=SELECT+Primary_Diagnosis__c,Chronic_Conditions__c+FROM+Clinical_Record__c+WHERE+Member_ID__c='{{member_id}}'"
          inputParameters:
            - name: member_id
              in: query
          operations:
            - name: get-clinical-record
              method: GET
    - type: http
      namespace: servicenow
      baseUri: "https://molina.service-now.com/api/now"
      authentication:
        type: basic
        username: "$secrets.servicenow_user"
        password: "$secrets.servicenow_password"
      resources:
        - name: incidents
          path: "/table/incident"
          operations:
            - name: create-incident
              method: POST
    - type: http
      namespace: zoom
      baseUri: "https://api.zoom.us/v2"
      authentication:
        type: bearer
        token: "$secrets.zoom_token"
      resources:
        - name: meetings
          path: "/users/me/meetings"
          operations:
            - name: create-meeting
              method: POST
    - type: http
      namespace: msteams
      baseUri: "https://graph.microsoft.com/v1.0"
      authentication:
        type: bearer
        token: "$secrets.msgraph_token"
      resources:
        - name: channel-messages
          path: "/teams/{{team_id}}/channels/{{channel_id}}/messages"
          inputParameters:
            - name: team_id
              in: path
            - name: channel_id
              in: path
          operations:
            - name: post-message
              method: POST

Behavioral Health Referral Intake ▼

behavioral-health referral salesforce zoom servicenow microsoft-teams

Creates a behavioral health referral by logging the request in Salesforce, scheduling a telehealth intake with Zoom, creating a ServiceNow case for tracking, and notifying the behavioral health team via Microsoft Teams.

naftiko: "0.5"
info:
  label: "Behavioral Health Referral Intake"
  description: "Creates a behavioral health referral by logging the request in Salesforce, scheduling a telehealth intake with Zoom, creating a ServiceNow case for tracking, and notifying the behavioral health team via Microsoft Teams."
  tags:
    - behavioral-health
    - referral
    - salesforce
    - zoom
    - servicenow
    - microsoft-teams
capability:
  exposes:
    - type: mcp
      namespace: behavioral-health
      port: 8080
      tools:
        - name: create-bh-referral
          description: "Given member and referral details, create a behavioral health referral across Salesforce, Zoom, ServiceNow, and Teams."
          inputParameters:
            - name: member_id
              in: body
              type: string
              description: "The Molina member ID."
            - name: referral_type
              in: body
              type: string
              description: "Type of behavioral health referral (e.g., outpatient therapy, substance use, crisis)."
            - name: urgency
              in: body
              type: string
              description: "Urgency level (routine, urgent, emergent)."
          steps:
            - name: create-referral
              type: call
              call: "salesforce.create-bh-referral"
              with:
                member_id: "{{member_id}}"
                referral_type: "{{referral_type}}"
                urgency: "{{urgency}}"
            - name: schedule-intake
              type: call
              call: "zoom.create-meeting"
              with:
                topic: "BH Intake - {{member_id}} - {{referral_type}}"
                start_time: "2026-04-02T10:00:00Z"
                duration: "60"
            - name: create-tracking-case
              type: call
              call: "servicenow.create-incident"
              with:
                short_description: "BH Referral: {{referral_type}} - {{member_id}}"
                category: "behavioral_health"
                urgency: "{{urgency}}"
                description: "Behavioral health referral for member {{member_id}}. Type: {{referral_type}}. Salesforce: {{create-referral.id}}. Intake: {{schedule-intake.join_url}}."
            - name: notify-bh-team
              type: call
              call: "msteams.post-message"
              with:
                team_id: "behavioral-health-team"
                channel_id: "referrals"
                message: "New BH referral for member {{member_id}}. Type: {{referral_type}}. Urgency: {{urgency}}. Case: {{create-tracking-case.number}}. Intake: {{schedule-intake.join_url}}."
  consumes:
    - type: http
      namespace: salesforce
      baseUri: "https://molina.my.salesforce.com/services/data/v58.0"
      authentication:
        type: bearer
        token: "$secrets.salesforce_token"
      resources:
        - name: bh-referrals
          path: "/sobjects/BH_Referral__c"
          operations:
            - name: create-bh-referral
              method: POST
    - type: http
      namespace: zoom
      baseUri: "https://api.zoom.us/v2"
      authentication:
        type: bearer
        token: "$secrets.zoom_token"
      resources:
        - name: meetings
          path: "/users/me/meetings"
          operations:
            - name: create-meeting
              method: POST
    - type: http
      namespace: servicenow
      baseUri: "https://molina.service-now.com/api/now"
      authentication:
        type: basic
        username: "$secrets.servicenow_user"
        password: "$secrets.servicenow_password"
      resources:
        - name: incidents
          path: "/table/incident"
          operations:
            - name: create-incident
              method: POST
    - type: http
      namespace: msteams
      baseUri: "https://graph.microsoft.com/v1.0"
      authentication:
        type: bearer
        token: "$secrets.msgraph_token"
      resources:
        - name: channel-messages
          path: "/teams/{{team_id}}/channels/{{channel_id}}/messages"
          inputParameters:
            - name: team_id
              in: path
            - name: channel_id
              in: path
          operations:
            - name: post-message
              method: POST

Care Gap Outreach Campaign ▼

care-gaps outreach salesforce jira microsoft-teams

Launches a care gap outreach campaign by querying overdue preventive care members from Salesforce, creating a Jira project to track outreach tasks, and notifying the outreach team via Microsoft Teams.

naftiko: "0.5"
info:
  label: "Care Gap Outreach Campaign"
  description: "Launches a care gap outreach campaign by querying overdue preventive care members from Salesforce, creating a Jira project to track outreach tasks, and notifying the outreach team via Microsoft Teams."
  tags:
    - care-gaps
    - outreach
    - salesforce
    - jira
    - microsoft-teams
capability:
  exposes:
    - type: mcp
      namespace: care-gap-outreach
      port: 8080
      tools:
        - name: launch-care-gap-campaign
          description: "Given a care measure and region, query overdue members, create Jira tracking, and notify the outreach team."
          inputParameters:
            - name: care_measure
              in: body
              type: string
              description: "The HEDIS care measure (e.g., breast cancer screening, A1C testing, well-child visit)."
            - name: region
              in: body
              type: string
              description: "The geographic region to target."
          steps:
            - name: query-overdue-members
              type: call
              call: "salesforce.query-care-gaps"
              with:
                care_measure: "{{care_measure}}"
                region: "{{region}}"
            - name: create-campaign-project
              type: call
              call: "jira.create-issue"
              with:
                project: "OUTREACH"
                summary: "Care Gap Campaign: {{care_measure}} - {{region}}"
                description: "Outreach campaign for {{care_measure}} in {{region}}. {{query-overdue-members.totalSize}} members identified."
                issuetype: "Epic"
            - name: notify-outreach-team
              type: call
              call: "msteams.post-message"
              with:
                team_id: "outreach-team"
                channel_id: "campaigns"
                message: "Care gap campaign launched: {{care_measure}} in {{region}}. {{query-overdue-members.totalSize}} members identified. Jira: {{create-campaign-project.key}}."
  consumes:
    - type: http
      namespace: salesforce
      baseUri: "https://molina.my.salesforce.com/services/data/v58.0"
      authentication:
        type: bearer
        token: "$secrets.salesforce_token"
      resources:
        - name: care-gaps
          path: "/query/?q=SELECT+Id,Member_ID__c,Care_Measure__c,Last_Service_Date__c+FROM+Care_Gap__c+WHERE+Care_Measure__c='{{care_measure}}'+AND+Region__c='{{region}}'+AND+Status__c='Open'"
          inputParameters:
            - name: care_measure
              in: query
            - name: region
              in: query
          operations:
            - name: query-care-gaps
              method: GET
    - type: http
      namespace: jira
      baseUri: "https://molina.atlassian.net/rest/api/3"
      authentication:
        type: basic
        username: "$secrets.jira_user"
        password: "$secrets.jira_token"
      resources:
        - name: issues
          path: "/issue"
          operations:
            - name: create-issue
              method: POST
    - type: http
      namespace: msteams
      baseUri: "https://graph.microsoft.com/v1.0"
      authentication:
        type: bearer
        token: "$secrets.msgraph_token"
      resources:
        - name: channel-messages
          path: "/teams/{{team_id}}/channels/{{channel_id}}/messages"
          inputParameters:
            - name: team_id
              in: path
            - name: channel_id
              in: path
          operations:
            - name: post-message
              method: POST

Care Gap Outreach Orchestrator ▼

care-coordination care-gaps salesforce microsoft-teams servicenow

Identifies members with care gaps from Salesforce Health Cloud, generates an outreach list, sends personalized reminders via Microsoft Teams, and logs outreach activities in ServiceNow.

naftiko: "0.5"
info:
  label: "Care Gap Outreach Orchestrator"
  description: "Identifies members with care gaps from Salesforce Health Cloud, generates an outreach list, sends personalized reminders via Microsoft Teams, and logs outreach activities in ServiceNow."
  tags:
    - care-coordination
    - care-gaps
    - salesforce
    - microsoft-teams
    - servicenow
capability:
  exposes:
    - type: mcp
      namespace: care-gaps
      port: 8080
      tools:
        - name: trigger-care-gap-outreach
          description: "Given a care gap type and date range, query members with open gaps, send outreach notifications, and log activities."
          inputParameters:
            - name: gap_type
              in: body
              type: string
              description: "The type of care gap (e.g., annual_wellness, diabetes_screening)."
            - name: region
              in: body
              type: string
              description: "The geographic region to target."
          steps:
            - name: find-members
              type: call
              call: "salesforce.query-care-gaps"
              with:
                gap_type: "{{gap_type}}"
                region: "{{region}}"
            - name: notify-coordinators
              type: call
              call: "msteams.post-message"
              with:
                team_id: "care-coordination-team"
                channel_id: "care-gaps"
                message: "Care gap outreach for {{gap_type}} in {{region}}: {{find-members.totalSize}} members identified. Please begin outreach."
            - name: log-outreach
              type: call
              call: "servicenow.create-incident"
              with:
                short_description: "Care gap outreach: {{gap_type}} - {{region}}"
                category: "care_coordination"
                description: "Outreach initiated for {{find-members.totalSize}} members with {{gap_type}} gaps in {{region}}."
  consumes:
    - type: http
      namespace: salesforce
      baseUri: "https://molina.my.salesforce.com/services/data/v58.0"
      authentication:
        type: bearer
        token: "$secrets.salesforce_token"
      resources:
        - name: care-gaps
          path: "/query/?q=SELECT+Member_ID__c,Name,Gap_Type__c+FROM+Care_Gap__c+WHERE+Gap_Type__c='{{gap_type}}'+AND+Region__c='{{region}}'+AND+Status__c='Open'"
          inputParameters:
            - name: gap_type
              in: query
            - name: region
              in: query
          operations:
            - name: query-care-gaps
              method: GET
    - type: http
      namespace: msteams
      baseUri: "https://graph.microsoft.com/v1.0"
      authentication:
        type: bearer
        token: "$secrets.msgraph_token"
      resources:
        - name: channel-messages
          path: "/teams/{{team_id}}/channels/{{channel_id}}/messages"
          inputParameters:
            - name: team_id
              in: path
            - name: channel_id
              in: path
          operations:
            - name: post-message
              method: POST
    - type: http
      namespace: servicenow
      baseUri: "https://molina.service-now.com/api/now"
      authentication:
        type: basic
        username: "$secrets.servicenow_user"
        password: "$secrets.servicenow_password"
      resources:
        - name: incidents
          path: "/table/incident"
          operations:
            - name: create-incident
              method: POST

Claims Analytics Trend Report ▼

claims analytics snowflake power-bi microsoft-teams

Generates a claims trend analysis by querying Snowflake for month-over-month claim volumes, denial rates, and average processing times, then refreshes the Power BI dashboard and notifies leadership.

naftiko: "0.5"
info:
  label: "Claims Analytics Trend Report"
  description: "Generates a claims trend analysis by querying Snowflake for month-over-month claim volumes, denial rates, and average processing times, then refreshes the Power BI dashboard and notifies leadership."
  tags:
    - claims
    - analytics
    - snowflake
    - power-bi
    - microsoft-teams
capability:
  exposes:
    - type: mcp
      namespace: claims-trends
      port: 8080
      tools:
        - name: generate-claims-trend
          description: "Given a date range, generate claims trend analytics and refresh the dashboard."
          inputParameters:
            - name: start_month
              in: body
              type: string
              description: "Start month in YYYY-MM format."
            - name: end_month
              in: body
              type: string
              description: "End month in YYYY-MM format."
          steps:
            - name: query-trends
              type: call
              call: "snowflake.execute-query"
              with:
                start_month: "{{start_month}}"
                end_month: "{{end_month}}"
            - name: refresh-dashboard
              type: call
              call: "powerbi.refresh-dataset"
              with:
                dataset_id: "claims-trends-dataset"
            - name: notify-leadership
              type: call
              call: "msteams.post-message"
              with:
                team_id: "executive-team"
                channel_id: "claims-insights"
                message: "Claims trend report for {{start_month}} to {{end_month}} generated. {{query-trends.rowCount}} data points analyzed. Dashboard refreshed."
  consumes:
    - type: http
      namespace: snowflake
      baseUri: "https://molina.snowflakecomputing.com/api/v2"
      authentication:
        type: bearer
        token: "$secrets.snowflake_token"
      resources:
        - name: statements
          path: "/statements"
          operations:
            - name: execute-query
              method: POST
    - type: http
      namespace: powerbi
      baseUri: "https://api.powerbi.com/v1.0/myorg"
      authentication:
        type: bearer
        token: "$secrets.powerbi_token"
      resources:
        - name: datasets
          path: "/datasets/{{dataset_id}}/refreshes"
          inputParameters:
            - name: dataset_id
              in: path
          operations:
            - name: refresh-dataset
              method: POST
    - type: http
      namespace: msteams
      baseUri: "https://graph.microsoft.com/v1.0"
      authentication:
        type: bearer
        token: "$secrets.msgraph_token"
      resources:
        - name: channel-messages
          path: "/teams/{{team_id}}/channels/{{channel_id}}/messages"
          inputParameters:
            - name: team_id
              in: path
            - name: channel_id
              in: path
          operations:
            - name: post-message
              method: POST

Claims Batch Processing Pipeline ▼

claims batch-processing snowflake salesforce microsoft-teams

Pulls a batch of unprocessed claims from Snowflake, validates them against eligibility in Salesforce, updates adjudication status, and sends a summary report to the claims team via Microsoft Teams.

naftiko: "0.5"
info:
  label: "Claims Batch Processing Pipeline"
  description: "Pulls a batch of unprocessed claims from Snowflake, validates them against eligibility in Salesforce, updates adjudication status, and sends a summary report to the claims team via Microsoft Teams."
  tags:
    - claims
    - batch-processing
    - snowflake
    - salesforce
    - microsoft-teams
capability:
  exposes:
    - type: mcp
      namespace: claims-batch
      port: 8080
      tools:
        - name: process-claims-batch
          description: "Given a batch date, pull unprocessed claims from Snowflake, validate eligibility, and report results."
          inputParameters:
            - name: batch_date
              in: body
              type: string
              description: "The batch processing date in YYYY-MM-DD format."
          steps:
            - name: pull-claims
              type: call
              call: "snowflake.execute-query"
              with:
                batch_date: "{{batch_date}}"
            - name: validate-eligibility
              type: call
              call: "salesforce.validate-batch"
              with:
                batch_date: "{{batch_date}}"
                claim_count: "{{pull-claims.rowCount}}"
            - name: report-results
              type: call
              call: "msteams.post-message"
              with:
                team_id: "claims-team"
                channel_id: "batch-processing"
                message: "Batch {{batch_date}} complete. {{pull-claims.rowCount}} claims processed. Validation: {{validate-eligibility.status}}."
  consumes:
    - type: http
      namespace: snowflake
      baseUri: "https://molina.snowflakecomputing.com/api/v2"
      authentication:
        type: bearer
        token: "$secrets.snowflake_token"
      resources:
        - name: statements
          path: "/statements"
          operations:
            - name: execute-query
              method: POST
    - type: http
      namespace: salesforce
      baseUri: "https://molina.my.salesforce.com/services/data/v58.0"
      authentication:
        type: bearer
        token: "$secrets.salesforce_token"
      resources:
        - name: batch-validation
          path: "/services/apexrest/claims/validate"
          operations:
            - name: validate-batch
              method: POST
    - type: http
      namespace: msteams
      baseUri: "https://graph.microsoft.com/v1.0"
      authentication:
        type: bearer
        token: "$secrets.msgraph_token"
      resources:
        - name: channel-messages
          path: "/teams/{{team_id}}/channels/{{channel_id}}/messages"
          inputParameters:
            - name: team_id
              in: path
            - name: channel_id
              in: path
          operations:
            - name: post-message
              method: POST

Claims Denial Appeal Workflow ▼

claims appeals salesforce servicenow sharepoint microsoft-teams

When a claim is denied, retrieves denial details from Salesforce, creates an appeal case in ServiceNow, attaches supporting documents from SharePoint, and notifies the member services team in Microsoft Teams.

naftiko: "0.5"
info:
  label: "Claims Denial Appeal Workflow"
  description: "When a claim is denied, retrieves denial details from Salesforce, creates an appeal case in ServiceNow, attaches supporting documents from SharePoint, and notifies the member services team in Microsoft Teams."
  tags:
    - claims
    - appeals
    - salesforce
    - servicenow
    - sharepoint
    - microsoft-teams
capability:
  exposes:
    - type: mcp
      namespace: claims-appeals
      port: 8080
      tools:
        - name: initiate-denial-appeal
          description: "Given a denied claim number, retrieve denial details, create an appeal case, attach documentation, and notify the member services team."
          inputParameters:
            - name: claim_number
              in: body
              type: string
              description: "The denied claim number."
            - name: appeal_reason
              in: body
              type: string
              description: "The reason for the appeal."
          steps:
            - name: get-denial
              type: call
              call: "salesforce.get-claim"
              with:
                claim_number: "{{claim_number}}"
            - name: create-appeal-case
              type: call
              call: "servicenow.create-incident"
              with:
                short_description: "Claim appeal: {{claim_number}}"
                category: "claims_appeal"
                description: "Appeal for claim {{claim_number}}. Denial reason: {{get-denial.Denial_Reason__c}}. Appeal reason: {{appeal_reason}}."
            - name: attach-docs
              type: call
              call: "sharepoint.get-file"
              with:
                site_id: "claims_docs_site"
                file_path: "Appeals/{{claim_number}}"
            - name: notify-team
              type: call
              call: "msteams.post-message"
              with:
                team_id: "member-services-team"
                channel_id: "appeals"
                message: "Appeal initiated for claim {{claim_number}}. Case: {{create-appeal-case.number}}. Docs: {{attach-docs.webUrl}}."
  consumes:
    - type: http
      namespace: salesforce
      baseUri: "https://molina.my.salesforce.com/services/data/v58.0"
      authentication:
        type: bearer
        token: "$secrets.salesforce_token"
      resources:
        - name: claims
          path: "/query/?q=SELECT+Id,Denial_Reason__c,Billed_Amount__c+FROM+Claim__c+WHERE+Claim_Number__c='{{claim_number}}'"
          inputParameters:
            - name: claim_number
              in: query
          operations:
            - name: get-claim
              method: GET
    - type: http
      namespace: servicenow
      baseUri: "https://molina.service-now.com/api/now"
      authentication:
        type: basic
        username: "$secrets.servicenow_user"
        password: "$secrets.servicenow_password"
      resources:
        - name: incidents
          path: "/table/incident"
          operations:
            - name: create-incident
              method: POST
    - type: http
      namespace: sharepoint
      baseUri: "https://graph.microsoft.com/v1.0/sites"
      authentication:
        type: bearer
        token: "$secrets.msgraph_token"
      resources:
        - name: files
          path: "/{{site_id}}/drive/root:/{{file_path}}"
          inputParameters:
            - name: site_id
              in: path
            - name: file_path
              in: path
          operations:
            - name: get-file
              method: GET
    - type: http
      namespace: msteams
      baseUri: "https://graph.microsoft.com/v1.0"
      authentication:
        type: bearer
        token: "$secrets.msgraph_token"
      resources:
        - name: channel-messages
          path: "/teams/{{team_id}}/channels/{{channel_id}}/messages"
          inputParameters:
            - name: team_id
              in: path
            - name: channel_id
              in: path
          operations:
            - name: post-message
              method: POST

Claims Status Checker ▼

claims claims-processing salesforce

Retrieves the current status of a healthcare claim by claim number, including adjudication state, payment amount, and denial reason if applicable.

naftiko: "0.5"
info:
  label: "Claims Status Checker"
  description: "Retrieves the current status of a healthcare claim by claim number, including adjudication state, payment amount, and denial reason if applicable."
  tags:
    - claims
    - claims-processing
    - salesforce
capability:
  exposes:
    - type: mcp
      namespace: claims-status
      port: 8080
      tools:
        - name: get-claim-status
          description: "Look up a Molina claim by claim number. Returns adjudication status, billed amount, allowed amount, paid amount, and denial reason."
          inputParameters:
            - name: claim_number
              in: body
              type: string
              description: "The claim number to look up."
          call: "salesforce.get-claim"
          with:
            claim_number: "{{claim_number}}"
          outputParameters:
            - name: status
              type: string
              mapping: "$.records[0].Adjudication_Status__c"
            - name: billed_amount
              type: string
              mapping: "$.records[0].Billed_Amount__c"
            - name: paid_amount
              type: string
              mapping: "$.records[0].Paid_Amount__c"
            - name: denial_reason
              type: string
              mapping: "$.records[0].Denial_Reason__c"
  consumes:
    - type: http
      namespace: salesforce
      baseUri: "https://molina.my.salesforce.com/services/data/v58.0"
      authentication:
        type: bearer
        token: "$secrets.salesforce_token"
      resources:
        - name: claims
          path: "/query/?q=SELECT+Id,Adjudication_Status__c,Billed_Amount__c,Paid_Amount__c,Denial_Reason__c+FROM+Claim__c+WHERE+Claim_Number__c='{{claim_number}}'"
          inputParameters:
            - name: claim_number
              in: query
          operations:
            - name: get-claim
              method: GET

Compliance Audit Trail Generator ▼

compliance audit salesforce servicenow snowflake sharepoint

Generates an audit trail report by querying activity logs from Salesforce and ServiceNow, aggregating results in Snowflake, and uploading the report to SharePoint for compliance review.

naftiko: "0.5"
info:
  label: "Compliance Audit Trail Generator"
  description: "Generates an audit trail report by querying activity logs from Salesforce and ServiceNow, aggregating results in Snowflake, and uploading the report to SharePoint for compliance review."
  tags:
    - compliance
    - audit
    - salesforce
    - servicenow
    - snowflake
    - sharepoint
capability:
  exposes:
    - type: mcp
      namespace: compliance-audit
      port: 8080
      tools:
        - name: generate-audit-trail
          description: "Given an audit period, pull activity logs from multiple systems and generate a consolidated audit report."
          inputParameters:
            - name: start_date
              in: body
              type: string
              description: "Audit period start date in YYYY-MM-DD format."
            - name: end_date
              in: body
              type: string
              description: "Audit period end date in YYYY-MM-DD format."
            - name: audit_type
              in: body
              type: string
              description: "Type of audit (e.g., claims, enrollment, grievance)."
          steps:
            - name: pull-salesforce-logs
              type: call
              call: "salesforce.query-audit-logs"
              with:
                start_date: "{{start_date}}"
                end_date: "{{end_date}}"
                audit_type: "{{audit_type}}"
            - name: pull-servicenow-logs
              type: call
              call: "servicenow.query-audit-logs"
              with:
                start_date: "{{start_date}}"
                end_date: "{{end_date}}"
            - name: aggregate-in-snowflake
              type: call
              call: "snowflake.execute-query"
              with:
                start_date: "{{start_date}}"
                end_date: "{{end_date}}"
                audit_type: "{{audit_type}}"
            - name: upload-report
              type: call
              call: "sharepoint.create-folder"
              with:
                site_id: "compliance_site"
                folder_path: "AuditReports/{{audit_type}}/{{start_date}}_{{end_date}}"
  consumes:
    - type: http
      namespace: salesforce
      baseUri: "https://molina.my.salesforce.com/services/data/v58.0"
      authentication:
        type: bearer
        token: "$secrets.salesforce_token"
      resources:
        - name: audit-logs
          path: "/query/?q=SELECT+Action__c,Timestamp__c,User__c+FROM+Audit_Log__c+WHERE+Timestamp__c>={{start_date}}+AND+Timestamp__c<={{end_date}}+AND+Type__c='{{audit_type}}'"
          inputParameters:
            - name: start_date
              in: query
            - name: end_date
              in: query
            - name: audit_type
              in: query
          operations:
            - name: query-audit-logs
              method: GET
    - type: http
      namespace: servicenow
      baseUri: "https://molina.service-now.com/api/now"
      authentication:
        type: basic
        username: "$secrets.servicenow_user"
        password: "$secrets.servicenow_password"
      resources:
        - name: audit-logs
          path: "/table/sys_audit?sysparm_query=sys_created_onBETWEEN{{start_date}}@{{end_date}}"
          inputParameters:
            - name: start_date
              in: query
            - name: end_date
              in: query
          operations:
            - name: query-audit-logs
              method: GET
    - type: http
      namespace: snowflake
      baseUri: "https://molina.snowflakecomputing.com/api/v2"
      authentication:
        type: bearer
        token: "$secrets.snowflake_token"
      resources:
        - name: statements
          path: "/statements"
          operations:
            - name: execute-query
              method: POST
    - type: http
      namespace: sharepoint
      baseUri: "https://graph.microsoft.com/v1.0/sites"
      authentication:
        type: bearer
        token: "$secrets.msgraph_token"
      resources:
        - name: folders
          path: "/{{site_id}}/drive/root:/{{folder_path}}"
          inputParameters:
            - name: site_id
              in: path
            - name: folder_path
              in: path
          operations:
            - name: create-folder
              method: POST

Confluence Knowledge Base Search ▼

knowledge-management confluence

Searches the Molina Confluence knowledge base by keyword and returns matching article titles, spaces, and URLs.

naftiko: "0.5"
info:
  label: "Confluence Knowledge Base Search"
  description: "Searches the Molina Confluence knowledge base by keyword and returns matching article titles, spaces, and URLs."
  tags:
    - knowledge-management
    - confluence
capability:
  exposes:
    - type: mcp
      namespace: knowledge-base
      port: 8080
      tools:
        - name: search-knowledge-base
          description: "Search Confluence for knowledge articles by keyword. Returns page titles, space keys, and URLs."
          inputParameters:
            - name: query
              in: body
              type: string
              description: "The search keyword or phrase."
          call: "confluence.search-content"
          with:
            query: "{{query}}"
  consumes:
    - type: http
      namespace: confluence
      baseUri: "https://molina.atlassian.net/wiki/rest/api"
      authentication:
        type: basic
        username: "$secrets.confluence_user"
        password: "$secrets.confluence_api_token"
      resources:
        - name: content
          path: "/content/search?cql=text~'{{query}}'"
          inputParameters:
            - name: query
              in: query
          operations:
            - name: search-content
              method: GET

Disease Management Program Enrollment ▼

disease-management care-coordination salesforce zoom servicenow microsoft-teams

Enrolls a member in a disease management program by creating a program record in Salesforce, scheduling an initial assessment via Zoom, assigning a care manager in ServiceNow, and notifying the DM team via Microsoft Teams.

naftiko: "0.5"
info:
  label: "Disease Management Program Enrollment"
  description: "Enrolls a member in a disease management program by creating a program record in Salesforce, scheduling an initial assessment via Zoom, assigning a care manager in ServiceNow, and notifying the DM team via Microsoft Teams."
  tags:
    - disease-management
    - care-coordination
    - salesforce
    - zoom
    - servicenow
    - microsoft-teams
capability:
  exposes:
    - type: mcp
      namespace: disease-management
      port: 8080
      tools:
        - name: enroll-in-dm-program
          description: "Given a member ID and program type, enroll the member, schedule assessment, assign care manager, and notify team."
          inputParameters:
            - name: member_id
              in: body
              type: string
              description: "The Molina member ID."
            - name: program_type
              in: body
              type: string
              description: "The disease management program (e.g., diabetes, CHF, COPD)."
          steps:
            - name: create-enrollment
              type: call
              call: "salesforce.create-dm-enrollment"
              with:
                member_id: "{{member_id}}"
                program_type: "{{program_type}}"
            - name: schedule-assessment
              type: call
              call: "zoom.create-meeting"
              with:
                topic: "DM Initial Assessment - {{member_id}} - {{program_type}}"
                start_time: "2026-04-01T09:00:00Z"
                duration: "45"
            - name: assign-care-manager
              type: call
              call: "servicenow.create-incident"
              with:
                short_description: "DM assignment: {{program_type}} - {{member_id}}"
                category: "disease_management"
                assigned_group: "DM_Care_Managers"
                description: "Assign care manager for member {{member_id}} in {{program_type}} program. Enrollment: {{create-enrollment.id}}. Assessment: {{schedule-assessment.join_url}}."
            - name: notify-dm-team
              type: call
              call: "msteams.post-message"
              with:
                team_id: "dm-team"
                channel_id: "enrollments"
                message: "Member {{member_id}} enrolled in {{program_type}} DM program. Case: {{assign-care-manager.number}}. Assessment: {{schedule-assessment.join_url}}."
  consumes:
    - type: http
      namespace: salesforce
      baseUri: "https://molina.my.salesforce.com/services/data/v58.0"
      authentication:
        type: bearer
        token: "$secrets.salesforce_token"
      resources:
        - name: dm-enrollments
          path: "/sobjects/DM_Enrollment__c"
          operations:
            - name: create-dm-enrollment
              method: POST
    - type: http
      namespace: zoom
      baseUri: "https://api.zoom.us/v2"
      authentication:
        type: bearer
        token: "$secrets.zoom_token"
      resources:
        - name: meetings
          path: "/users/me/meetings"
          operations:
            - name: create-meeting
              method: POST
    - type: http
      namespace: servicenow
      baseUri: "https://molina.service-now.com/api/now"
      authentication:
        type: basic
        username: "$secrets.servicenow_user"
        password: "$secrets.servicenow_password"
      resources:
        - name: incidents
          path: "/table/incident"
          operations:
            - name: create-incident
              method: POST
    - type: http
      namespace: msteams
      baseUri: "https://graph.microsoft.com/v1.0"
      authentication:
        type: bearer
        token: "$secrets.msgraph_token"
      resources:
        - name: channel-messages
          path: "/teams/{{team_id}}/channels/{{channel_id}}/messages"
          inputParameters:
            - name: team_id
              in: path
            - name: channel_id
              in: path
          operations:
            - name: post-message
              method: POST

Employee Onboarding Orchestrator ▼

hr onboarding workday servicenow sharepoint microsoft-teams

On new hire creation in Workday, opens a ServiceNow onboarding ticket, provisions a SharePoint folder for HR documents, and sends a Microsoft Teams welcome message.

naftiko: "0.5"
info:
  label: "Employee Onboarding Orchestrator"
  description: "On new hire creation in Workday, opens a ServiceNow onboarding ticket, provisions a SharePoint folder for HR documents, and sends a Microsoft Teams welcome message."
  tags:
    - hr
    - onboarding
    - workday
    - servicenow
    - sharepoint
    - microsoft-teams
capability:
  exposes:
    - type: mcp
      namespace: hr-onboarding
      port: 8080
      tools:
        - name: trigger-onboarding
          description: "Given a Workday employee ID and start date, orchestrate the full onboarding sequence across ServiceNow, SharePoint, and Microsoft Teams."
          inputParameters:
            - name: workday_employee_id
              in: body
              type: string
              description: "The Workday worker ID for the new hire."
            - name: start_date
              in: body
              type: string
              description: "The employee start date in YYYY-MM-DD format."
            - name: department
              in: body
              type: string
              description: "The department the new hire is joining."
          steps:
            - name: get-employee
              type: call
              call: "workday.get-worker"
              with:
                worker_id: "{{workday_employee_id}}"
            - name: open-ticket
              type: call
              call: "servicenow.create-incident"
              with:
                short_description: "New hire onboarding: {{get-employee.full_name}}"
                category: "hr_onboarding"
                assigned_group: "IT_Onboarding"
                description: "Onboarding for {{get-employee.full_name}} starting {{start_date}} in {{department}}."
            - name: provision-folder
              type: call
              call: "sharepoint.create-folder"
              with:
                site_id: "hr_onboarding_site"
                folder_path: "OnboardingDocs/{{get-employee.full_name}}_{{start_date}}"
            - name: send-welcome
              type: call
              call: "msteams.post-message"
              with:
                team_id: "hr-team"
                channel_id: "new-hires"
                message: "Welcome to Molina Healthcare, {{get-employee.first_name}}! Your onboarding ticket is {{open-ticket.number}}. Documents: {{provision-folder.webUrl}}."
  consumes:
    - type: http
      namespace: workday
      baseUri: "https://wd2-impl-services1.workday.com/ccx/api/v1"
      authentication:
        type: bearer
        token: "$secrets.workday_token"
      resources:
        - name: workers
          path: "/workers/{{worker_id}}"
          inputParameters:
            - name: worker_id
              in: path
          operations:
            - name: get-worker
              method: GET
    - type: http
      namespace: servicenow
      baseUri: "https://molina.service-now.com/api/now"
      authentication:
        type: basic
        username: "$secrets.servicenow_user"
        password: "$secrets.servicenow_password"
      resources:
        - name: incidents
          path: "/table/incident"
          operations:
            - name: create-incident
              method: POST
    - type: http
      namespace: sharepoint
      baseUri: "https://graph.microsoft.com/v1.0/sites"
      authentication:
        type: bearer
        token: "$secrets.msgraph_token"
      resources:
        - name: folders
          path: "/{{site_id}}/drive/root:/{{folder_path}}"
          inputParameters:
            - name: site_id
              in: path
            - name: folder_path
              in: path
          operations:
            - name: create-folder
              method: POST
    - type: http
      namespace: msteams
      baseUri: "https://graph.microsoft.com/v1.0"
      authentication:
        type: bearer
        token: "$secrets.msgraph_token"
      resources:
        - name: channel-messages
          path: "/teams/{{team_id}}/channels/{{channel_id}}/messages"
          inputParameters:
            - name: team_id
              in: path
            - name: channel_id
              in: path
          operations:
            - name: post-message
              method: POST

Encounter Data Submission Pipeline ▼

encounters regulatory snowflake sharepoint microsoft-teams

Compiles encounter data from Snowflake, validates formatting against CMS requirements, uploads to SharePoint for state filing, and notifies the encounter data team via Microsoft Teams.

naftiko: "0.5"
info:
  label: "Encounter Data Submission Pipeline"
  description: "Compiles encounter data from Snowflake, validates formatting against CMS requirements, uploads to SharePoint for state filing, and notifies the encounter data team via Microsoft Teams."
  tags:
    - encounters
    - regulatory
    - snowflake
    - sharepoint
    - microsoft-teams
capability:
  exposes:
    - type: mcp
      namespace: encounter-submission
      port: 8080
      tools:
        - name: submit-encounter-data
          description: "Given a state and reporting period, compile, validate, and submit encounter data."
          inputParameters:
            - name: state
              in: body
              type: string
              description: "The state for encounter submission."
            - name: reporting_period
              in: body
              type: string
              description: "The reporting period (e.g., 2026-Q1)."
          steps:
            - name: compile-encounters
              type: call
              call: "snowflake.execute-query"
              with:
                state: "{{state}}"
                reporting_period: "{{reporting_period}}"
            - name: upload-submission
              type: call
              call: "sharepoint.create-folder"
              with:
                site_id: "encounter_site"
                folder_path: "Submissions/{{state}}/{{reporting_period}}"
            - name: notify-team
              type: call
              call: "msteams.post-message"
              with:
                team_id: "encounter-data-team"
                channel_id: "submissions"
                message: "Encounter data for {{state}} ({{reporting_period}}) compiled: {{compile-encounters.rowCount}} records. Submission: {{upload-submission.webUrl}}."
  consumes:
    - type: http
      namespace: snowflake
      baseUri: "https://molina.snowflakecomputing.com/api/v2"
      authentication:
        type: bearer
        token: "$secrets.snowflake_token"
      resources:
        - name: statements
          path: "/statements"
          operations:
            - name: execute-query
              method: POST
    - type: http
      namespace: sharepoint
      baseUri: "https://graph.microsoft.com/v1.0/sites"
      authentication:
        type: bearer
        token: "$secrets.msgraph_token"
      resources:
        - name: folders
          path: "/{{site_id}}/drive/root:/{{folder_path}}"
          inputParameters:
            - name: site_id
              in: path
            - name: folder_path
              in: path
          operations:
            - name: create-folder
              method: POST
    - type: http
      namespace: msteams
      baseUri: "https://graph.microsoft.com/v1.0"
      authentication:
        type: bearer
        token: "$secrets.msgraph_token"
      resources:
        - name: channel-messages
          path: "/teams/{{team_id}}/channels/{{channel_id}}/messages"
          inputParameters:
            - name: team_id
              in: path
            - name: channel_id
              in: path
          operations:
            - name: post-message
              method: POST

Molina Healthcare Workflow 1 ▼

healthcare operations salesforce