UnitedHealth Group Capabilities
Naftiko 0.5 capability definitions for UnitedHealth Group - 100 capabilities showing integration workflows and service orchestrations.
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Annual Performance Review Kickoff
▼
hr performance-management communication
Initiates annual performance review cycles in Workday for a department and notifies managers via Teams.
naftiko: "0.5"
info:
title: Annual Performance Review Kickoff
version: "1.0"
description: Initiates annual performance review cycles in Workday for a department and notifies managers via Teams.
tags: [hr, performance-management, communication]
capability:
exposes:
type: mcp
port: 8080
tools:
- name: kickoff_performance_review
description: Starts performance review cycle in Workday and messages department managers.
inputParameters:
- name: department
in: body
required: true
type: string
- name: review_cycle
in: body
required: true
type: string
steps:
- name: start-review-cycle
call:
operationId: initiatePerformanceReview
input:
department: "{{department}}"
cycle: "{{review_cycle}}"
- name: notify-managers
call:
operationId: sendTeamsMessage
input:
channelId: "{{department}}-managers"
message: "Performance review cycle {{review_cycle}} is now open for {{department}}. Please complete evaluations by the deadline."
consumes:
- type: http
baseUri: https://wd3-impl-services1.workday.com/ccx/service/unitedhealth
authentication:
type: bearer
token: $secrets.workday_token
resources:
- path: /performanceReviews
operations:
- id: initiatePerformanceReview
method: POST
- type: http
baseUri: https://graph.microsoft.com/v1.0
authentication:
type: bearer
token: $secrets.ms_graph_token
resources:
- path: /teams/messages
operations:
- id: sendTeamsMessage
method: POST
Azure Clinical Infrastructure Scaler
▼
infrastructure clinical healthcare azure
Monitors clinical application load and auto-scales Azure Kubernetes Service clusters with Datadog alerting.
naftiko: "0.5"
info:
title: Azure Clinical Infrastructure Scaler
version: "1.0"
description: Monitors clinical application load and auto-scales Azure Kubernetes Service clusters with Datadog alerting.
tags: [infrastructure, clinical, healthcare, azure]
capability:
exposes:
type: mcp
port: 8080
tools:
- name: scale_clinical_infra
description: Checks application load metrics and scales AKS cluster nodes accordingly.
inputParameters:
- name: cluster_name
in: body
required: true
type: string
- name: threshold_cpu
in: body
required: true
type: number
steps:
- name: check-load
call:
operationId: queryMetric
input:
query: "avg:kubernetes.cpu.usage{cluster:{{cluster_name}}}"
- name: scale-cluster
call:
operationId: scaleNodePool
input:
clusterName: "{{cluster_name}}"
nodeCount: "{{check-load.recommended_nodes}}"
- name: alert-team
call:
operationId: sendTeamsMessage
input:
channelId: "platform-engineering"
message: "AKS cluster {{cluster_name}} scaled. CPU: {{check-load.value}}%."
consumes:
- type: http
baseUri: https://api.datadoghq.com/api/v1
authentication:
type: apikey
name: DD-API-KEY
in: header
key: $secrets.datadog_api_key
resources:
- path: /metrics/query
operations:
- id: queryMetric
method: GET
- type: http
baseUri: https://management.azure.com/subscriptions/uhc-sub
authentication:
type: bearer
token: $secrets.azure_mgmt_token
resources:
- path: /resourceGroups/clinical/providers/Microsoft.ContainerService/managedClusters/{clusterName}
operations:
- id: scaleNodePool
method: PATCH
- type: http
baseUri: https://graph.microsoft.com/v1.0
authentication:
type: bearer
token: $secrets.ms_graph_token
resources:
- path: /teams/messages
operations:
- id: sendTeamsMessage
method: POST
Care Coordination Referral Workflow
▼
clinical provider-network healthcare communication
Creates a specialist referral, verifies provider network status, and notifies the care coordinator via Teams.
naftiko: "0.5"
info:
title: Care Coordination Referral Workflow
version: "1.0"
description: Creates a specialist referral, verifies provider network status, and notifies the care coordinator via Teams.
tags: [clinical, provider-network, healthcare, communication]
capability:
exposes:
type: mcp
port: 8080
tools:
- name: create_referral
description: Submits a referral, validates provider network tier, and sends confirmation to the care team.
inputParameters:
- name: member_id
in: body
required: true
type: string
- name: provider_npi
in: body
required: true
type: string
- name: diagnosis_code
in: body
required: true
type: string
steps:
- name: verify-provider
call:
operationId: getNetworkTier
input:
providerNpi: "{{provider_npi}}"
planId: "{{member_id}}"
- name: create-referral
call:
operationId: submitReferral
input:
memberId: "{{member_id}}"
providerNpi: "{{provider_npi}}"
diagnosisCode: "{{diagnosis_code}}"
networkTier: "{{verify-provider.tier}}"
- name: notify-coordinator
call:
operationId: sendTeamsMessage
input:
channelId: "care-coordination"
message: "Referral {{create-referral.referral_id}} created for member {{member_id}} to provider {{provider_npi}} ({{verify-provider.tier}})."
consumes:
- type: http
baseUri: https://api.uhc.com/provider-directory/v2
authentication:
type: bearer
token: $secrets.uhc_provider_token
resources:
- path: /providers/{providerNpi}/tier
operations:
- id: getNetworkTier
method: GET
- type: http
baseUri: https://api.uhc.com/referrals/v1
authentication:
type: bearer
token: $secrets.uhc_referral_token
resources:
- path: /referrals
operations:
- id: submitReferral
method: POST
- type: http
baseUri: https://graph.microsoft.com/v1.0
authentication:
type: bearer
token: $secrets.ms_graph_token
resources:
- path: /teams/messages
operations:
- id: sendTeamsMessage
method: POST
Chronic Condition Management Outreach
▼
population-health clinical healthcare salesforce
Identifies members with unmanaged chronic conditions and initiates care management outreach through Salesforce and Teams.
naftiko: "0.5"
info:
title: Chronic Condition Management Outreach
version: "1.0"
description: Identifies members with unmanaged chronic conditions and initiates care management outreach through Salesforce and Teams.
tags: [population-health, clinical, healthcare, salesforce]
capability:
exposes:
type: mcp
port: 8080
tools:
- name: trigger_chronic_outreach
description: Queries high-risk chronic condition members and creates care management outreach tasks.
inputParameters:
- name: condition_code
in: body
required: true
type: string
- name: risk_threshold
in: body
required: true
type: number
steps:
- name: identify-members
call:
operationId: executeQuery
input:
statement: "SELECT member_id, risk_score, last_visit_date FROM chronic_conditions WHERE condition='{{condition_code}}' AND risk_score > {{risk_threshold}}"
- name: create-outreach
call:
operationId: createCases
input:
members: "{{identify-members.results}}"
caseType: "chronic_condition_outreach"
condition: "{{condition_code}}"
- name: notify-team
call:
operationId: sendTeamsMessage
input:
channelId: "care-management"
message: "Chronic condition outreach initiated for {{condition_code}} — high-risk members identified."
consumes:
- type: http
baseUri: https://uhc-analytics.snowflakecomputing.com/api/v2
authentication:
type: bearer
token: $secrets.snowflake_token
resources:
- path: /statements
operations:
- id: executeQuery
method: POST
- type: http
baseUri: https://unitedhealth.my.salesforce.com/services/data/v58.0
authentication:
type: bearer
token: $secrets.salesforce_token
resources:
- path: /sobjects/Case
operations:
- id: createCases
method: POST
- type: http
baseUri: https://graph.microsoft.com/v1.0
authentication:
type: bearer
token: $secrets.ms_graph_token
resources:
- path: /teams/messages
operations:
- id: sendTeamsMessage
method: POST
Claim Eob Retrieval
▼
claims member-services healthcare
Retrieves the explanation of benefits document for a processed claim from the UHC claims platform.
naftiko: "0.5"
info:
title: Claim Explanation of Benefits Retrieval
version: "1.0"
description: Retrieves the explanation of benefits document for a processed claim from the UHC claims platform.
tags: [claims, member-services, healthcare]
capability:
exposes:
type: mcp
port: 8080
tools:
- name: get_eob
description: Returns the EOB details including patient responsibility, allowed amounts, and payment summary.
inputParameters:
- name: claim_id
in: query
required: true
type: string
- name: member_id
in: query
required: true
type: string
call:
operationId: getExplanationOfBenefits
input:
claimId: "{{claim_id}}"
memberId: "{{member_id}}"
outputParameters:
- name: patient_responsibility
type: number
- name: allowed_amount
type: number
- name: payment_date
type: string
consumes:
- type: http
baseUri: https://api.uhc.com/claims/v2
authentication:
type: bearer
token: $secrets.uhc_claims_token
resources:
- path: /claims/{claimId}/eob
operations:
- id: getExplanationOfBenefits
method: GET
Claims Adjudication Exception Handler
▼
claims itsm healthcare
Detects claims adjudication exceptions, routes to appropriate reviewer, and logs in ServiceNow.
naftiko: "0.5"
info:
title: Claims Adjudication Exception Handler
version: "1.0"
description: Detects claims adjudication exceptions, routes to appropriate reviewer, and logs in ServiceNow.
tags: [claims, itsm, healthcare]
capability:
exposes:
type: mcp
port: 8080
tools:
- name: handle_adjudication_exception
description: Retrieves exception details, creates a review task, and logs an incident for tracking.
inputParameters:
- name: claim_id
in: body
required: true
type: string
- name: exception_code
in: body
required: true
type: string
steps:
- name: get-exception
call:
operationId: getClaimException
input:
claimId: "{{claim_id}}"
exceptionCode: "{{exception_code}}"
- name: create-review
call:
operationId: createIncident
input:
short_description: "Claims adjudication exception {{exception_code}} on claim {{claim_id}}"
urgency: "2"
category: "claims_exception"
- name: notify-reviewer
call:
operationId: sendTeamsMessage
input:
channelId: "claims-exceptions"
message: "Exception {{exception_code}} on claim {{claim_id}} requires review. Incident: {{create-review.number}}."
consumes:
- type: http
baseUri: https://api.uhc.com/claims/v2
authentication:
type: bearer
token: $secrets.uhc_claims_token
resources:
- path: /claims/{claimId}/exceptions
operations:
- id: getClaimException
method: GET
- type: http
baseUri: https://unitedhealth.service-now.com/api/now/v1
authentication:
type: basic
username: $secrets.snow_user
password: $secrets.snow_password
resources:
- path: /table/incident
operations:
- id: createIncident
method: POST
- type: http
baseUri: https://graph.microsoft.com/v1.0
authentication:
type: bearer
token: $secrets.ms_graph_token
resources:
- path: /teams/messages
operations:
- id: sendTeamsMessage
method: POST
Claims Batch Processing Monitor
▼
claims itsm healthcare observability
Monitors nightly claims batch processing jobs, detects failures, and creates incident tickets with notifications.
naftiko: "0.5"
info:
title: Claims Batch Processing Monitor
version: "1.0"
description: Monitors nightly claims batch processing jobs, detects failures, and creates incident tickets with notifications.
tags: [claims, itsm, healthcare, observability]
capability:
exposes:
type: mcp
port: 8080
tools:
- name: monitor_claims_batch
description: Checks batch job status in Datadog, creates incidents for failures, and alerts the operations team.
inputParameters:
- name: batch_job_name
in: body
required: true
type: string
- name: expected_completion_time
in: body
required: true
type: string
steps:
- name: check-batch-status
call:
operationId: queryMetric
input:
query: "avg:batch.job.status{job:{{batch_job_name}}}"
from: "{{expected_completion_time}}"
- name: create-incident
call:
operationId: createIncident
input:
short_description: "Claims batch {{batch_job_name}} processing failure"
urgency: "1"
category: "batch_processing"
- name: alert-ops
call:
operationId: sendTeamsMessage
input:
channelId: "claims-operations"
message: "Claims batch {{batch_job_name}} failed. Incident {{create-incident.number}} created."
consumes:
- type: http
baseUri: https://api.datadoghq.com/api/v1
authentication:
type: apikey
name: DD-API-KEY
in: header
key: $secrets.datadog_api_key
resources:
- path: /metrics/query
operations:
- id: queryMetric
method: GET
- type: http
baseUri: https://unitedhealth.service-now.com/api/now/v1
authentication:
type: basic
username: $secrets.snow_user
password: $secrets.snow_password
resources:
- path: /table/incident
operations:
- id: createIncident
method: POST
- type: http
baseUri: https://graph.microsoft.com/v1.0
authentication:
type: bearer
token: $secrets.ms_graph_token
resources:
- path: /teams/messages
operations:
- id: sendTeamsMessage
method: POST
Claims Data Lake Ingestion Monitor
▼
analytics claims healthcare azure
Monitors claims data ingestion into the Azure Data Lake, detects lag or failures, and triggers remediation.
naftiko: "0.5"
info:
title: Claims Data Lake Ingestion Monitor
version: "1.0"
description: Monitors claims data ingestion into the Azure Data Lake, detects lag or failures, and triggers remediation.
tags: [analytics, claims, healthcare, azure]
capability:
exposes:
type: mcp
port: 8080
tools:
- name: monitor_data_ingestion
description: Checks ingestion pipeline metrics, detects anomalies, and creates remediation incidents.
inputParameters:
- name: pipeline_name
in: body
required: true
type: string
- name: max_lag_hours
in: body
required: true
type: integer
steps:
- name: check-pipeline
call:
operationId: queryMetric
input:
query: "avg:data_lake.ingestion.lag{pipeline:{{pipeline_name}}}"
- name: create-incident
call:
operationId: createIncident
input:
short_description: "Data lake ingestion lag for {{pipeline_name}}"
urgency: "2"
category: "data_engineering"
- name: notify-team
call:
operationId: sendTeamsMessage
input:
channelId: "data-engineering"
message: "Data ingestion alert: {{pipeline_name}} lag detected. Incident: {{create-incident.number}}."
consumes:
- type: http
baseUri: https://api.datadoghq.com/api/v1
authentication:
type: apikey
name: DD-API-KEY
in: header
key: $secrets.datadog_api_key
resources:
- path: /metrics/query
operations:
- id: queryMetric
method: GET
- type: http
baseUri: https://unitedhealth.service-now.com/api/now/v1
authentication:
type: basic
username: $secrets.snow_user
password: $secrets.snow_password
resources:
- path: /table/incident
operations:
- id: createIncident
method: POST
- type: http
baseUri: https://graph.microsoft.com/v1.0
authentication:
type: bearer
token: $secrets.ms_graph_token
resources:
- path: /teams/messages
operations:
- id: sendTeamsMessage
method: POST
Claims Denial Appeal Workflow
▼
claims member-services healthcare
Retrieves a denied claim, generates an appeal letter, and submits it to the appeals queue with notification to the member.
naftiko: "0.5"
info:
title: Claims Denial Appeal Workflow
version: "1.0"
description: Retrieves a denied claim, generates an appeal letter, and submits it to the appeals queue with notification to the member.
tags: [claims, member-services, healthcare]
capability:
exposes:
type: mcp
port: 8080
tools:
- name: process_denial_appeal
description: Retrieves denial details, creates appeal submission, and notifies the member via Teams.
inputParameters:
- name: claim_id
in: body
required: true
type: string
- name: member_id
in: body
required: true
type: string
- name: appeal_reason
in: body
required: true
type: string
steps:
- name: get-denial-details
call:
operationId: getClaimDenial
input:
claimId: "{{claim_id}}"
memberId: "{{member_id}}"
- name: submit-appeal
call:
operationId: createAppeal
input:
claimId: "{{claim_id}}"
reason: "{{appeal_reason}}"
denialCode: "{{get-denial-details.denial_code}}"
- name: notify-member
call:
operationId: sendTeamsMessage
input:
channelId: "member-services-alerts"
message: "Appeal {{submit-appeal.appeal_id}} submitted for claim {{claim_id}} — denial code {{get-denial-details.denial_code}}."
consumes:
- type: http
baseUri: https://api.uhc.com/claims/v2
authentication:
type: bearer
token: $secrets.uhc_claims_token
resources:
- path: /claims/{claimId}/denial
operations:
- id: getClaimDenial
method: GET
- type: http
baseUri: https://api.uhc.com/appeals/v1
authentication:
type: bearer
token: $secrets.uhc_appeals_token
resources:
- path: /appeals
operations:
- id: createAppeal
method: POST
- type: http
baseUri: https://graph.microsoft.com/v1.0
authentication:
type: bearer
token: $secrets.ms_graph_token
resources:
- path: /teams/messages
operations:
- id: sendTeamsMessage
method: POST
Clinical Data Pipeline Health Check
▼
data observability itsm healthcare
Queries Datadog for clinical data pipeline lag metrics and creates a ServiceNow incident if thresholds are exceeded.
naftiko: "0.5"
info:
title: Clinical Data Pipeline Health Check
version: "1.0"
description: Queries Datadog for clinical data pipeline lag metrics and creates a ServiceNow incident if thresholds are exceeded.
tags: [data, observability, itsm, healthcare]
capability:
exposes:
type: mcp
port: 8080
tools:
- name: check_pipeline_health
description: Checks data pipeline lag and creates an incident if lag exceeds acceptable limits.
inputParameters:
- name: pipeline_name
in: query
required: true
type: string
- name: max_lag_minutes
in: query
required: true
type: integer
steps:
- name: query-lag-metric
call:
operationId: queryMetric
input:
query: "avg:pipeline.lag{pipeline:{{pipeline_name}}}"
- name: create-incident
call:
operationId: createIncident
input:
short_description: "Data pipeline {{pipeline_name}} lag of {{query-lag-metric.value}} minutes exceeds threshold of {{max_lag_minutes}}"
urgency: "2"
category: data
consumes:
- type: http
baseUri: https://api.datadoghq.com/api/v1
authentication:
type: apikey
name: DD-API-KEY
in: header
key: $secrets.datadog_api_key
resources:
- path: /metrics/query
operations:
- id: queryMetric
method: GET
- type: http
baseUri: https://unitedhealth.service-now.com/api/now/v1
authentication:
type: basic
username: $secrets.snow_user
password: $secrets.snow_password
resources:
- path: /table/incident
operations:
- id: createIncident
method: POST
Clinical Incident Response Chain
▼
itsm observability incident-response healthcare
Detects clinical system incidents via Datadog, creates a ServiceNow ticket, and alerts on-call via PagerDuty.
naftiko: "0.5"
info:
title: Clinical Incident Response Chain
version: "1.0"
description: Detects clinical system incidents via Datadog, creates a ServiceNow ticket, and alerts on-call via PagerDuty.
tags: [itsm, observability, incident-response, healthcare]
capability:
exposes:
type: mcp
port: 8080
tools:
- name: respond_clinical_incident
description: Handles a clinical system alert by creating a ServiceNow incident and paging the on-call team.
inputParameters:
- name: monitor_id
in: body
required: true
type: string
- name: severity
in: body
required: true
type: string
steps:
- name: get-monitor-alert
call:
operationId: getMonitor
input:
monitorId: "{{monitor_id}}"
- name: create-snow-incident
call:
operationId: createIncident
input:
short_description: "Clinical system alert: {{get-monitor-alert.name}}"
urgency: "{{severity}}"
category: healthcare
- name: trigger-pagerduty
call:
operationId: createPagerDutyIncident
input:
title: "{{get-monitor-alert.name}}"
severity: "{{severity}}"
serviceId: $secrets.pd_clinical_service_id
consumes:
- type: http
baseUri: https://api.datadoghq.com/api/v1
authentication:
type: apikey
name: DD-API-KEY
in: header
key: $secrets.datadog_api_key
resources:
- path: /monitor/{monitorId}
operations:
- id: getMonitor
method: GET
- type: http
baseUri: https://unitedhealth.service-now.com/api/now/v1
authentication:
type: basic
username: $secrets.snow_user
password: $secrets.snow_password
resources:
- path: /table/incident
operations:
- id: createIncident
method: POST
- type: http
baseUri: https://api.pagerduty.com
authentication:
type: bearer
token: $secrets.pagerduty_token
resources:
- path: /incidents
operations:
- id: createPagerDutyIncident
method: POST
Clinical Quality Measure Reporting
▼
clinical analytics healthcare confluence
Aggregates clinical quality measures from Snowflake and publishes a report to Confluence for regulatory review.
naftiko: "0.5"
info:
title: Clinical Quality Measure Reporting
version: "1.0"
description: Aggregates clinical quality measures from Snowflake and publishes a report to Confluence for regulatory review.
tags: [clinical, analytics, healthcare, confluence]
capability:
exposes:
type: mcp
port: 8080
tools:
- name: generate_quality_report
description: Queries quality metrics, formats a report, and publishes to the regulatory Confluence space.
inputParameters:
- name: reporting_period
in: body
required: true
type: string
- name: measure_set
in: body
required: true
type: string
steps:
- name: query-measures
call:
operationId: executeQuery
input:
statement: "SELECT measure_code, numerator, denominator, rate FROM quality_measures WHERE period='{{reporting_period}}' AND measure_set='{{measure_set}}'"
- name: publish-report
call:
operationId: createContent
input:
type: "page"
title: "Quality Measures Report — {{reporting_period}}"
space: "REG"
body: "{{query-measures.results}}"
consumes:
- type: http
baseUri: https://uhc-analytics.snowflakecomputing.com/api/v2
authentication:
type: bearer
token: $secrets.snowflake_token
resources:
- path: /statements
operations:
- id: executeQuery
method: POST
- type: http
baseUri: https://unitedhealth.atlassian.net/wiki/rest/api
authentication:
type: basic
username: $secrets.confluence_user
password: $secrets.confluence_api_token
resources:
- path: /content
operations:
- id: createContent
method: POST
Clinical Trial Eligibility Screener
▼
clinical population-health healthcare
Screens member clinical data against active clinical trial criteria and notifies the research team of eligible candidates.
naftiko: "0.5"
info:
title: Clinical Trial Eligibility Screener
version: "1.0"
description: Screens member clinical data against active clinical trial criteria and notifies the research team of eligible candidates.
tags: [clinical, population-health, healthcare]
capability:
exposes:
type: mcp
port: 8080
tools:
- name: screen_trial_eligibility
description: Queries member clinical profile, matches against trial criteria, and notifies the research coordinator.
inputParameters:
- name: trial_id
in: body
required: true
type: string
- name: population_criteria
in: body
required: true
type: string
steps:
- name: query-candidates
call:
operationId: executeQuery
input:
statement: "SELECT member_id, age, diagnosis_codes FROM clinical_profiles WHERE {{population_criteria}}"
- name: match-criteria
call:
operationId: matchTrialCriteria
input:
trialId: "{{trial_id}}"
candidates: "{{query-candidates.results}}"
- name: notify-research
call:
operationId: sendTeamsMessage
input:
channelId: "clinical-research"
message: "Trial {{trial_id}} screening complete. {{match-criteria.eligible_count}} eligible candidates identified."
consumes:
- type: http
baseUri: https://uhc-analytics.snowflakecomputing.com/api/v2
authentication:
type: bearer
token: $secrets.snowflake_token
resources:
- path: /statements
operations:
- id: executeQuery
method: POST
- type: http
baseUri: https://api.optum.com/clinical-research/v1
authentication:
type: bearer
token: $secrets.optum_research_token
resources:
- path: /trials/{trialId}/screen
operations:
- id: matchTrialCriteria
method: POST
- type: http
baseUri: https://graph.microsoft.com/v1.0
authentication:
type: bearer
token: $secrets.ms_graph_token
resources:
- path: /teams/messages
operations:
- id: sendTeamsMessage
method: POST
Confluence Clinical Runbook Search
▼
itsm knowledge-management confluence
Searches the Confluence knowledge base for clinical operations runbooks by keyword.
naftiko: "0.5"
info:
title: Confluence Clinical Runbook Search
version: "1.0"
description: Searches the Confluence knowledge base for clinical operations runbooks by keyword.
tags: [itsm, knowledge-management, confluence]
capability:
exposes:
type: mcp
port: 8080
tools:
- name: search_runbooks
description: Returns matching runbook pages with titles, last updated dates, and links.
inputParameters:
- name: query
in: query
required: true
type: string
- name: space_key
in: query
required: true
type: string
call:
operationId: searchContent
input:
cql: "space={{space_key}} AND type=page AND text~'{{query}}'"
limit: "20"
outputParameters:
- name: results
type: array
- name: total_size
type: integer
consumes:
- type: http
baseUri: https://unitedhealth.atlassian.net/wiki/rest/api
authentication:
type: basic
username: $secrets.confluence_user
password: $secrets.confluence_api_token
resources:
- path: /content/search
operations:
- id: searchContent
method: GET
Databricks Claims Ml Pipeline Trigger
▼
analytics claims healthcare databricks
Triggers a Databricks ML pipeline for claims cost prediction, monitors execution, and publishes results to Power BI.
naftiko: "0.5"
info:
title: Databricks Claims ML Pipeline Trigger
version: "1.0"
description: Triggers a Databricks ML pipeline for claims cost prediction, monitors execution, and publishes results to Power BI.
tags: [analytics, claims, healthcare, databricks]
capability:
exposes:
type: mcp
port: 8080
tools:
- name: trigger_claims_ml_pipeline
description: Starts the ML pipeline job, monitors completion, and triggers dashboard refresh.
inputParameters:
- name: pipeline_id
in: body
required: true
type: string
- name: model_version
in: body
required: true
type: string
steps:
- name: trigger-pipeline
call:
operationId: triggerJob
input:
pipelineId: "{{pipeline_id}}"
parameters: "model_version={{model_version}}"
- name: refresh-dashboard
call:
operationId: refreshDataset
input:
datasetId: "claims-predictions"
workspaceId: "analytics-workspace"
- name: notify-team
call:
operationId: sendTeamsMessage
input:
channelId: "data-science"
message: "Claims ML pipeline {{pipeline_id}} completed (model: {{model_version}}). Dashboard refreshed."
consumes:
- type: http
baseUri: https://unitedhealth-databricks.azuredatabricks.net/api/2.1
authentication:
type: bearer
token: $secrets.databricks_token
resources:
- path: /jobs/run-now
operations:
- id: triggerJob
method: POST
- type: http
baseUri: https://api.powerbi.com/v1.0/myorg
authentication:
type: bearer
token: $secrets.powerbi_token
resources:
- path: /groups/analytics-workspace/datasets/claims-predictions/refreshes
operations:
- id: refreshDataset
method: POST
- type: http
baseUri: https://graph.microsoft.com/v1.0
authentication:
type: bearer
token: $secrets.ms_graph_token
resources:
- path: /teams/messages
operations:
- id: sendTeamsMessage
method: POST
Datadog Optum Api Latency Monitor
▼
observability datadog healthcare
Queries Datadog for P99 latency metrics of Optum platform APIs over a specified time window.
naftiko: "0.5"
info:
title: Datadog Optum API Latency Monitor
version: "1.0"
description: Queries Datadog for P99 latency metrics of Optum platform APIs over a specified time window.
tags: [observability, datadog, healthcare]
capability:
exposes:
type: mcp
port: 8080
tools:
- name: get_api_latency
description: Returns P99, P95, and P50 latency percentiles for the specified API service.
inputParameters:
- name: service_name
in: query
required: true
type: string
- name: time_range
in: query
required: true
type: string
call:
operationId: queryMetric
input:
query: "p99:trace.http.request{service:{{service_name}}}"
from: "{{time_range}}"
outputParameters:
- name: p99_ms
type: number
- name: p95_ms
type: number
- name: p50_ms
type: number
consumes:
- type: http
baseUri: https://api.datadoghq.com/api/v1
authentication:
type: apikey
name: DD-API-KEY
in: header
key: $secrets.datadog_api_key
resources:
- path: /metrics/query
operations:
- id: queryMetric
method: GET
Datadog Slo Compliance Monitor
▼
observability reliability devops
Checks SLO error budget burn rates in Datadog and triggers a PagerDuty alert when thresholds are breached.
naftiko: "0.5"
info:
title: Datadog SLO Compliance Monitor
version: "1.0"
description: Checks SLO error budget burn rates in Datadog and triggers a PagerDuty alert when thresholds are breached.
tags: [observability, reliability, devops]
capability:
exposes:
type: mcp
port: 8080
tools:
- name: check_slo_compliance
description: Reads SLO burn rate and pages on-call if the error budget is critically consumed.
inputParameters:
- name: slo_id
in: query
required: true
type: string
steps:
- name: get-slo-status
call:
operationId: getSloStatus
input:
sloId: "{{slo_id}}"
- name: trigger-alert
call:
operationId: createPagerDutyIncident
input:
title: "SLO breach: {{get-slo-status.name}} error budget at {{get-slo-status.remaining_budget_pct}}%"
severity: critical
serviceId: $secrets.pd_slo_service_id
consumes:
- type: http
baseUri: https://api.datadoghq.com/api/v1
authentication:
type: apikey
name: DD-API-KEY
in: header
key: $secrets.datadog_api_key
resources:
- path: /slo/{sloId}
operations:
- id: getSloStatus
method: GET
- type: http
baseUri: https://api.pagerduty.com
authentication:
type: bearer
token: $secrets.pagerduty_token
resources:
- path: /incidents
operations:
- id: createPagerDutyIncident
method: POST
Dental Benefit Claim Processor
▼
claims enrollment healthcare
Processes dental claims by verifying benefit eligibility, adjudicating the claim, and sending the EOB to the member.
naftiko: "0.5"
info:
title: Dental Benefit Claim Processor
version: "1.0"
description: Processes dental claims by verifying benefit eligibility, adjudicating the claim, and sending the EOB to the member.
tags: [claims, enrollment, healthcare]
capability:
exposes:
type: mcp
port: 8080
tools:
- name: process_dental_claim
description: Verifies dental benefit eligibility, adjudicates the claim, and generates the EOB notification.
inputParameters:
- name: member_id
in: body
required: true
type: string
- name: claim_id
in: body
required: true
type: string
- name: procedure_code
in: body
required: true
type: string
steps:
- name: verify-dental-benefit
call:
operationId: verifyDentalEligibility
input:
memberId: "{{member_id}}"
procedureCode: "{{procedure_code}}"
- name: adjudicate-claim
call:
operationId: adjudicateDentalClaim
input:
claimId: "{{claim_id}}"
memberId: "{{member_id}}"
procedureCode: "{{procedure_code}}"
eligible: "{{verify-dental-benefit.eligible}}"
- name: send-eob
call:
operationId: sendEmail
input:
to: "{{member_id}}@uhc-member-portal.com"
subject: "Dental Claim EOB — {{claim_id}}"
body: "Your dental claim {{claim_id}} has been processed. Amount allowed: ${{adjudicate-claim.allowed_amount}}."
consumes:
- type: http
baseUri: https://api.uhc.com/dental/v1
authentication:
type: bearer
token: $secrets.uhc_dental_token
resources:
- path: /eligibility
operations:
- id: verifyDentalEligibility
method: GET
- type: http
baseUri: https://api.uhc.com/dental/v1
authentication:
type: bearer
token: $secrets.uhc_dental_token
resources:
- path: /claims/{claimId}/adjudicate
operations:
- id: adjudicateDentalClaim
method: POST
- type: http
baseUri: https://graph.microsoft.com/v1.0
authentication:
type: bearer
token: $secrets.ms_graph_token
resources:
- path: /me/sendMail
operations:
- id: sendEmail
method: POST
Edi 837 Claims Submission Validator
▼
claims compliance healthcare
Validates incoming EDI 837 claims submissions for format compliance, checks member eligibility, and routes to adjudication.
naftiko: "0.5"
info:
title: EDI 837 Claims Submission Validator
version: "1.0"
description: Validates incoming EDI 837 claims submissions for format compliance, checks member eligibility, and routes to adjudication.
tags: [claims, compliance, healthcare]
capability:
exposes:
type: mcp
port: 8080
tools:
- name: validate_edi_submission
description: Validates EDI format, checks member eligibility, and queues for adjudication processing.
inputParameters:
- name: submission_id
in: body
required: true
type: string
- name: submitter_id
in: body
required: true
type: string
steps:
- name: validate-format
call:
operationId: validateEDI
input:
submissionId: "{{submission_id}}"
submitterId: "{{submitter_id}}"
- name: check-eligibility
call:
operationId: batchEligibilityCheck
input:
submissionId: "{{submission_id}}"
claimCount: "{{validate-format.claim_count}}"
- name: route-to-adjudication
call:
operationId: queueForAdjudication
input:
submissionId: "{{submission_id}}"
validClaims: "{{check-eligibility.eligible_count}}"
rejectedClaims: "{{check-eligibility.rejected_count}}"
consumes:
- type: http
baseUri: https://api.uhc.com/edi/v1
authentication:
type: bearer
token: $secrets.uhc_edi_token
resources:
- path: /submissions/{submissionId}/validate
operations:
- id: validateEDI
method: POST
- type: http
baseUri: https://api.uhc.com/eligibility/v2
authentication:
type: bearer
token: $secrets.uhc_eligibility_token
resources:
- path: /batch-check
operations:
- id: batchEligibilityCheck
method: POST
- type: http
baseUri: https://api.uhc.com/claims/v2
authentication:
type: bearer
token: $secrets.uhc_claims_token
resources:
- path: /adjudication/queue
operations:
- id: queueForAdjudication
method: POST
Employee Benefits Enrollment Sync
▼
hr benefits finance
Reads open enrollment selections from Workday and syncs benefit elections to the benefits administration platform.
naftiko: "0.5"
info:
title: Employee Benefits Enrollment Sync
version: "1.0"
description: Reads open enrollment selections from Workday and syncs benefit elections to the benefits administration platform.
tags: [hr, benefits, finance]
capability:
exposes:
type: mcp
port: 8080
tools:
- name: sync_benefits_enrollment
description: Fetches enrollment data from Workday and pushes elections to the benefits platform.
inputParameters:
- name: enrollment_period
in: query
required: true
type: string
steps:
- name: get-elections
call:
operationId: getBenefitElections
input:
period: "{{enrollment_period}}"
- name: sync-to-benefits
call:
operationId: upsertBenefitEnrollments
input:
elections: "{{get-elections.elections}}"
period: "{{enrollment_period}}"
consumes:
- type: http
baseUri: https://wd3-impl-services1.workday.com/ccx/service/unitedhealth
authentication:
type: bearer
token: $secrets.workday_token
resources:
- path: /benefits/elections
operations:
- id: getBenefitElections
method: GET
- type: http
baseUri: https://api.benefitsplatform.com/v2
authentication:
type: bearer
token: $secrets.benefits_platform_token
resources:
- path: /enrollments
operations:
- id: upsertBenefitEnrollments
method: PUT
Employee Offboarding Workflow
▼
hr offboarding identity itsm
Terminates employee access in Okta, updates Workday status, and logs an IT offboarding ticket in ServiceNow.
naftiko: "0.5"
info:
title: Employee Offboarding Workflow
version: "1.0"
description: Terminates employee access in Okta, updates Workday status, and logs an IT offboarding ticket in ServiceNow.
tags: [hr, offboarding, identity, itsm]
capability:
exposes:
type: mcp
port: 8080
tools:
- name: offboard_employee
description: Deactivates Okta account, sets Workday status to terminated, and creates a ServiceNow offboarding ticket.
inputParameters:
- name: employee_id
in: body
required: true
type: string
- name: termination_date
in: body
required: true
type: string
steps:
- name: deactivate-okta
call:
operationId: deactivateOktaUser
input:
employeeId: "{{employee_id}}"
- name: update-workday-status
call:
operationId: terminateWorker
input:
employeeId: "{{employee_id}}"
terminationDate: "{{termination_date}}"
- name: create-snow-ticket
call:
operationId: createIncident
input:
short_description: "Offboarding: revoke all system access for employee {{employee_id}}"
category: hr
consumes:
- type: http
baseUri: https://unitedhealth.okta.com/api/v1
authentication:
type: bearer
token: $secrets.okta_token
resources:
- path: /users/{employeeId}/lifecycle/deactivate
operations:
- id: deactivateOktaUser
method: POST
- type: http
baseUri: https://wd3-impl-services1.workday.com/ccx/service/unitedhealth
authentication:
type: bearer
token: $secrets.workday_token
resources:
- path: /workers/{employeeId}/termination
operations:
- id: terminateWorker
method: POST
- type: http
baseUri: https://unitedhealth.service-now.com/api/now/v1
authentication:
type: basic
username: $secrets.snow_user
password: $secrets.snow_password
resources:
- path: /table/incident
operations:
- id: createIncident
method: POST
Employee Onboarding Orchestrator
▼
hr onboarding identity
Provisions new UnitedHealth Group employees across HR, identity, and collaboration systems.
naftiko: "0.5"
info:
title: Employee Onboarding Orchestrator
version: "1.0"
description: Provisions new UnitedHealth Group employees across HR, identity, and collaboration systems.
tags: [hr, onboarding, identity]
capability:
exposes:
type: mcp
port: 8080
tools:
- name: onboard_employee
description: Creates employee record in Workday, provisions Okta identity, and posts welcome message in Teams.
inputParameters:
- name: employee_id
in: body
required: true
type: string
- name: department
in: body
required: true
type: string
steps:
- name: create-workday-record
call:
operationId: createWorker
input:
employeeId: "{{employee_id}}"
department: "{{department}}"
- name: provision-okta
call:
operationId: createOktaUser
input:
login: "{{create-workday-record.email}}"
firstName: "{{create-workday-record.firstName}}"
lastName: "{{create-workday-record.lastName}}"
- name: send-teams-welcome
call:
operationId: sendTeamsMessage
input:
channelId: "{{department}}-general"
message: "Welcome {{create-workday-record.firstName}} {{create-workday-record.lastName}} to the team!"
consumes:
- type: http
baseUri: https://wd3-impl-services1.workday.com/ccx/service/unitedhealth
authentication:
type: bearer
token: $secrets.workday_token
resources:
- path: /workers
operations:
- id: createWorker
method: POST
- type: http
baseUri: https://unitedhealth.okta.com/api/v1
authentication:
type: bearer
token: $secrets.okta_token
resources:
- path: /users
operations:
- id: createOktaUser
method: POST
- type: http
baseUri: https://graph.microsoft.com/v1.0
authentication:
type: bearer
token: $secrets.ms_graph_token
resources:
- path: /teams/messages
operations:
- id: sendTeamsMessage
method: POST
Employer Group Renewal Workflow
▼
enrollment employer-group healthcare salesforce
Prepares employer group renewal package by pulling utilization data, calculating rate adjustments, and generating a proposal in Salesforce.
naftiko: "0.5"
info:
title: Employer Group Renewal Workflow
version: "1.0"
description: Prepares employer group renewal package by pulling utilization data, calculating rate adjustments, and generating a proposal in Salesforce.
tags: [enrollment, employer-group, healthcare, salesforce]
capability:
exposes:
type: mcp
port: 8080
tools:
- name: process_group_renewal
description: Queries group utilization, calculates renewal rates, and creates a Salesforce opportunity.
inputParameters:
- name: group_id
in: body
required: true
type: string
- name: renewal_date
in: body
required: true
type: string
steps:
- name: query-utilization
call:
operationId: executeQuery
input:
statement: "SELECT total_claims, avg_cost_per_member, loss_ratio FROM group_utilization WHERE group_id='{{group_id}}'"
- name: calculate-renewal
call:
operationId: calculateRenewal
input:
groupId: "{{group_id}}"
utilization: "{{query-utilization.results}}"
renewalDate: "{{renewal_date}}"
- name: create-opportunity
call:
operationId: createOpportunity
input:
groupId: "{{group_id}}"
renewalRate: "{{calculate-renewal.proposed_rate}}"
effectiveDate: "{{renewal_date}}"
consumes:
- type: http
baseUri: https://uhc-analytics.snowflakecomputing.com/api/v2
authentication:
type: bearer
token: $secrets.snowflake_token
resources:
- path: /statements
operations:
- id: executeQuery
method: POST
- type: http
baseUri: https://api.uhc.com/underwriting/v1
authentication:
type: bearer
token: $secrets.uhc_underwriting_token
resources:
- path: /renewals
operations:
- id: calculateRenewal
method: POST
- type: http
baseUri: https://unitedhealth.my.salesforce.com/services/data/v58.0
authentication:
type: bearer
token: $secrets.salesforce_token
resources:
- path: /sobjects/Opportunity
operations:
- id: createOpportunity
method: POST
Finops Cloud Cost Anomaly Responder
▼
finops cloud observability itsm
Detects AWS cost spikes via Datadog, logs a ServiceNow task, and posts a summary to the FinOps Teams channel.
naftiko: "0.5"
info:
title: FinOps Cloud Cost Anomaly Responder
version: "1.0"
description: Detects AWS cost spikes via Datadog, logs a ServiceNow task, and posts a summary to the FinOps Teams channel.
tags: [finops, cloud, observability, itsm]
capability:
exposes:
type: mcp
port: 8080
tools:
- name: respond_cost_anomaly
description: Handles a cloud cost anomaly by creating a task and notifying the FinOps team.
inputParameters:
- name: account_id
in: body
required: true
type: string
- name: threshold_pct
in: body
required: true
type: number
steps:
- name: get-cost-alert
call:
operationId: queryCostMetric
input:
accountId: "{{account_id}}"
thresholdPct: "{{threshold_pct}}"
- name: create-snow-task
call:
operationId: createServiceNowTask
input:
short_description: "AWS cost anomaly in account {{account_id}}: {{get-cost-alert.delta_pct}}% over threshold"
category: cloud-cost
- name: notify-finops
call:
operationId: sendTeamsAlert
input:
channelId: finops-alerts
message: "Cost anomaly detected in AWS account {{account_id}}. Task {{create-snow-task.number}} created."
consumes:
- type: http
baseUri: https://api.datadoghq.com/api/v1
authentication:
type: apikey
name: DD-API-KEY
in: header
key: $secrets.datadog_api_key
resources:
- path: /metrics/query
operations:
- id: queryCostMetric
method: GET
- type: http
baseUri: https://unitedhealth.service-now.com/api/now/v1
authentication:
type: basic
username: $secrets.snow_user
password: $secrets.snow_password
resources:
- path: /table/sc_task
operations:
- id: createServiceNowTask
method: POST
- type: http
baseUri: https://graph.microsoft.com/v1.0
authentication:
type: bearer
token: $secrets.ms_graph_token
resources:
- path: /teams/messages
operations:
- id: sendTeamsAlert
method: POST
Gdpr Data Subject Access Request Handler
▼
compliance privacy itsm communication
Logs a GDPR data subject access request in ServiceNow and notifies the Privacy team via Teams.
naftiko: "0.5"
info:
title: GDPR Data Subject Access Request Handler
version: "1.0"
description: Logs a GDPR data subject access request in ServiceNow and notifies the Privacy team via Teams.
tags: [compliance, privacy, itsm, communication]
capability:
exposes:
type: mcp
port: 8080
tools:
- name: handle_dsar
description: Creates a DSAR record in ServiceNow and alerts the privacy team for follow-up.
inputParameters:
- name: subject_name
in: body
required: true
type: string
- name: request_type
in: body
required: true
type: string
- name: submission_date
in: body
required: true
type: string
steps:
- name: create-dsar
call:
operationId: createDsarRecord
input:
subject: "{{subject_name}}"
type: "{{request_type}}"
submitted: "{{submission_date}}"
- name: notify-privacy
call:
operationId: sendTeamsMessage
input:
channelId: privacy-team
message: "New DSAR received from {{subject_name}} ({{request_type}}) on {{submission_date}}. Ticket: {{create-dsar.number}}."
consumes:
- type: http
baseUri: https://unitedhealth.service-now.com/api/now/v1
authentication:
type: basic
username: $secrets.snow_user
password: $secrets.snow_password
resources:
- path: /table/sn_privacy_dsar
operations:
- id: createDsarRecord
method: POST
- type: http
baseUri: https://graph.microsoft.com/v1.0
authentication:
type: bearer
token: $secrets.ms_graph_token
resources:
- path: /teams/messages
operations:
- id: sendTeamsMessage
method: POST
Github Clinical App Release Workflow
▼
devops clinical healthcare github
Orchestrates clinical application release by triggering a GitHub Actions build, running security scans, and creating a change request.
naftiko: "0.5"
info:
title: GitHub Clinical App Release Workflow
version: "1.0"
description: Orchestrates clinical application release by triggering a GitHub Actions build, running security scans, and creating a change request.
tags: [devops, clinical, healthcare, github]
capability:
exposes:
type: mcp
port: 8080
tools:
- name: release_clinical_app
description: Triggers CI/CD build, initiates security scan, and creates ServiceNow change request for production deployment.
inputParameters:
- name: repository
in: body
required: true
type: string
- name: release_tag
in: body
required: true
type: string
steps:
- name: trigger-build
call:
operationId: triggerWorkflow
input:
repo: "{{repository}}"
workflow: "release.yml"
ref: "{{release_tag}}"
- name: create-change
call:
operationId: createChangeRequest
input:
short_description: "Production release {{release_tag}} for {{repository}}"
category: "software"
risk: "moderate"
- name: notify-team
call:
operationId: sendTeamsMessage
input:
channelId: "clinical-releases"
message: "Release {{release_tag}} for {{repository}} initiated. Change request: {{create-change.number}}."
consumes:
- type: http
baseUri: https://api.github.com
authentication:
type: bearer
token: $secrets.github_token
resources:
- path: /repos/unitedhealth/{repo}/actions/workflows/{workflow}/dispatches
operations:
- id: triggerWorkflow
method: POST
- type: http
baseUri: https://unitedhealth.service-now.com/api/now/v1
authentication:
type: basic
username: $secrets.snow_user
password: $secrets.snow_password
resources:
- path: /table/change_request
operations:
- id: createChangeRequest
method: POST
- type: http
baseUri: https://graph.microsoft.com/v1.0
authentication:
type: bearer
token: $secrets.ms_graph_token
resources:
- path: /teams/messages
operations:
- id: sendTeamsMessage
method: POST
Github Security Vulnerability Triage
▼
security devops devex
Scans GitHub Dependabot alerts and creates Jira tickets for critical vulnerabilities in clinical system repositories.
naftiko: "0.5"
info:
title: GitHub Security Vulnerability Triage
version: "1.0"
description: Scans GitHub Dependabot alerts and creates Jira tickets for critical vulnerabilities in clinical system repositories.
tags: [security, devops, devex]
capability:
exposes:
type: mcp
port: 8080
tools:
- name: triage_security_vulnerabilities
description: Fetches Dependabot alerts and creates Jira tickets for critical findings.
inputParameters:
- name: org
in: query
required: true
type: string
- name: repo
in: query
required: true
type: string
steps:
- name: get-alerts
call:
operationId: getDependabotAlerts
input:
org: "{{org}}"
repo: "{{repo}}"
severity: critical
- name: create-jira-ticket
call:
operationId: createJiraIssue
input:
project: SEC
summary: "Critical vulnerability in {{repo}}: {{get-alerts.package_name}} {{get-alerts.vulnerable_version}}"
issuetype: Bug
priority: Critical
consumes:
- type: http
baseUri: https://api.github.com
authentication:
type: bearer
token: $secrets.github_token
resources:
- path: /repos/{org}/{repo}/dependabot/alerts
operations:
- id: getDependabotAlerts
method: GET
- type: http
baseUri: https://unitedhealth.atlassian.net/rest/api/3
authentication:
type: basic
username: $secrets.jira_user
password: $secrets.jira_token
resources:
- path: /issue
operations:
- id: createJiraIssue
method: POST
Gl Period Close Orchestrator
▼
finance erp period-close
Triggers the general ledger period close sequence in SAP S/4HANA and notifies Finance via Teams.
naftiko: "0.5"
info:
title: GL Period Close Orchestrator
version: "1.0"
description: Triggers the general ledger period close sequence in SAP S/4HANA and notifies Finance via Teams.
tags: [finance, erp, period-close]
capability:
exposes:
type: mcp
port: 8080
tools:
- name: run_period_close
description: Initiates GL period close in SAP and sends a completion notification to the Finance channel.
inputParameters:
- name: fiscal_period
in: body
required: true
type: string
- name: company_code
in: body
required: true
type: string
steps:
- name: trigger-period-close
call:
operationId: closeFiscalPeriod
input:
period: "{{fiscal_period}}"
companyCode: "{{company_code}}"
- name: notify-finance
call:
operationId: sendTeamsMessage
input:
channelId: finance-close
message: "GL period {{fiscal_period}} closed for company code {{company_code}}. Status: {{trigger-period-close.status}}."
consumes:
- type: http
baseUri: https://unitedhealth-sap.example.com/sap/opu/odata/sap
authentication:
type: basic
username: $secrets.sap_user
password: $secrets.sap_password
resources:
- path: /API_FISCALYEAR_PERIOD_SRV/PeriodClose
operations:
- id: closeFiscalPeriod
method: POST
- type: http
baseUri: https://graph.microsoft.com/v1.0
authentication:
type: bearer
token: $secrets.ms_graph_token
resources:
- path: /teams/messages
operations:
- id: sendTeamsMessage
method: POST
Hedis Quality Gap Closure Campaign
▼
population-health clinical healthcare salesforce
Identifies members with open HEDIS care gaps and triggers outreach campaigns via Salesforce.
naftiko: "0.5"
info:
title: HEDIS Quality Gap Closure Campaign
version: "1.0"
description: Identifies members with open HEDIS care gaps and triggers outreach campaigns via Salesforce.
tags: [population-health, clinical, healthcare, salesforce]
capability:
exposes:
type: mcp
port: 8080
tools:
- name: run_gap_closure_campaign
description: Queries open care gaps, creates Salesforce campaigns, and assigns outreach tasks to care advocates.
inputParameters:
- name: measure_code
in: body
required: true
type: string
- name: region
in: body
required: true
type: string
steps:
- name: query-open-gaps
call:
operationId: executeQuery
input:
statement: "SELECT member_id, gap_type FROM care_gaps WHERE measure='{{measure_code}}' AND region='{{region}}' AND status='open'"
- name: create-campaign
call:
operationId: createCampaign
input:
name: "HEDIS {{measure_code}} Gap Closure — {{region}}"
members: "{{query-open-gaps.results}}"
- name: assign-outreach
call:
operationId: createTasks
input:
campaignId: "{{create-campaign.campaign_id}}"
taskType: "outreach_call"
consumes:
- type: http
baseUri: https://uhc-analytics.snowflakecomputing.com/api/v2
authentication:
type: bearer
token: $secrets.snowflake_token
resources:
- path: /statements
operations:
- id: executeQuery
method: POST
- type: http
baseUri: https://unitedhealth.my.salesforce.com/services/data/v58.0
authentication:
type: bearer
token: $secrets.salesforce_token
resources:
- path: /sobjects/Campaign
operations:
- id: createCampaign
method: POST
- type: http
baseUri: https://unitedhealth.my.salesforce.com/services/data/v58.0
authentication:
type: bearer
token: $secrets.salesforce_token
resources:
- path: /sobjects/Task
operations:
- id: createTasks
method: POST
Hipaa Phi Access Audit Workflow
▼
compliance hipaa healthcare
Audits PHI access logs, identifies unusual access patterns, and creates compliance incidents with notification to the privacy officer.
naftiko: "0.5"
info:
title: HIPAA PHI Access Audit Workflow
version: "1.0"
description: Audits PHI access logs, identifies unusual access patterns, and creates compliance incidents with notification to the privacy officer.
tags: [compliance, hipaa, healthcare]
capability:
exposes:
type: mcp
port: 8080
tools:
- name: audit_phi_access
description: Queries PHI access logs, detects anomalies, and creates compliance incidents.
inputParameters:
- name: date_range_start
in: body
required: true
type: string
- name: date_range_end
in: body
required: true
type: string
steps:
- name: query-access-logs
call:
operationId: executeQuery
input:
statement: "SELECT user_id, member_id, access_time, data_type FROM phi_access_log WHERE access_time BETWEEN '{{date_range_start}}' AND '{{date_range_end}}' AND anomaly_flag=true"
- name: create-compliance-incident
call:
operationId: createIncident
input:
short_description: "HIPAA PHI access anomaly detected"
urgency: "1"
category: "hipaa_compliance"
- name: notify-privacy-officer
call:
operationId: sendTeamsMessage
input:
channelId: "privacy-compliance"
message: "PHI access anomalies detected. Compliance incident {{create-compliance-incident.number}} created for review."
consumes:
- type: http
baseUri: https://uhc-analytics.snowflakecomputing.com/api/v2
authentication:
type: bearer
token: $secrets.snowflake_token
resources:
- path: /statements
operations:
- id: executeQuery
method: POST
- type: http
baseUri: https://unitedhealth.service-now.com/api/now/v1
authentication:
type: basic
username: $secrets.snow_user
password: $secrets.snow_password
resources:
- path: /table/incident
operations:
- id: createIncident
method: POST
- type: http
baseUri: https://graph.microsoft.com/v1.0
authentication:
type: bearer
token: $secrets.ms_graph_token
resources:
- path: /teams/messages
operations:
- id: sendTeamsMessage
method: POST
Hipaa Security Incident Escalation
▼
security compliance itsm communication
Detects a potential HIPAA security event, creates a high-priority ServiceNow incident, and alerts the Privacy and Security team via Teams.
naftiko: "0.5"
info:
title: HIPAA Security Incident Escalation
version: "1.0"
description: Detects a potential HIPAA security event, creates a high-priority ServiceNow incident, and alerts the Privacy and Security team via Teams.
tags: [security, compliance, itsm, communication]
capability:
exposes:
type: mcp
port: 8080
tools:
- name: escalate_hipaa_incident
description: Logs a HIPAA security incident and notifies the privacy team.
inputParameters:
- name: event_type
in: body
required: true
type: string
- name: affected_records
in: body
required: true
type: integer
- name: source_system
in: body
required: true
type: string
steps:
- name: create-incident
call:
operationId: createIncident
input:
short_description: "HIPAA event: {{event_type}} in {{source_system}}"
urgency: "1"
category: security
affected_records: "{{affected_records}}"
- name: notify-privacy-team
call:
operationId: sendTeamsMessage
input:
channelId: privacy-security-alerts
message: "HIPAA incident {{create-incident.number}} created — {{event_type}} affecting {{affected_records}} records in {{source_system}}."
consumes:
- type: http
baseUri: https://unitedhealth.service-now.com/api/now/v1
authentication:
type: basic
username: $secrets.snow_user
password: $secrets.snow_password
resources:
- path: /table/incident
operations:
- id: createIncident
method: POST
- type: http
baseUri: https://graph.microsoft.com/v1.0
authentication:
type: bearer
token: $secrets.ms_graph_token
resources:
- path: /teams/messages
operations:
- id: sendTeamsMessage
method: POST
Infrastructure Health Digest
▼
observability reliability communication
Queries Datadog for host and service health metrics and posts a daily infrastructure digest to the Ops Teams channel.
naftiko: "0.5"
info:
title: Infrastructure Health Digest
version: "1.0"
description: Queries Datadog for host and service health metrics and posts a daily infrastructure digest to the Ops Teams channel.
tags: [observability, reliability, communication]
capability:
exposes:
type: mcp
port: 8080
tools:
- name: post_infra_digest
description: Retrieves infrastructure health summary from Datadog and posts daily digest.
inputParameters:
- name: environment
in: query
required: true
type: string
steps:
- name: get-host-metrics
call:
operationId: getHostMetrics
input:
env: "{{environment}}"
- name: post-digest
call:
operationId: sendTeamsMessage
input:
channelId: ops-digest
message: "Infrastructure digest ({{environment}}): {{get-host-metrics.healthy_hosts}} healthy, {{get-host-metrics.unhealthy_hosts}} unhealthy hosts."
consumes:
- type: http
baseUri: https://api.datadoghq.com/api/v1
authentication:
type: apikey
name: DD-API-KEY
in: header
key: $secrets.datadog_api_key
resources:
- path: /hosts
operations:
- id: getHostMetrics
method: GET
- type: http
baseUri: https://graph.microsoft.com/v1.0
authentication:
type: bearer
token: $secrets.ms_graph_token
resources:
- path: /teams/messages
operations:
- id: sendTeamsMessage
method: POST
It Change Management Approval
▼
itsm change-management communication
Submits an IT change request in ServiceNow and notifies the Change Advisory Board via Teams.
naftiko: "0.5"
info:
title: IT Change Management Approval
version: "1.0"
description: Submits an IT change request in ServiceNow and notifies the Change Advisory Board via Teams.
tags: [itsm, change-management, communication]
capability:
exposes:
type: mcp
port: 8080
tools:
- name: submit_change_request
description: Creates a change request in ServiceNow and alerts the CAB in Teams.
inputParameters:
- name: change_title
in: body
required: true
type: string
- name: risk_level
in: body
required: true
type: string
- name: planned_start
in: body
required: true
type: string
steps:
- name: create-change
call:
operationId: createChangeRequest
input:
short_description: "{{change_title}}"
risk: "{{risk_level}}"
start_date: "{{planned_start}}"
- name: notify-cab
call:
operationId: sendTeamsMessage
input:
channelId: change-advisory-board
message: "New change request {{create-change.number}}: {{change_title}} (Risk: {{risk_level}}) scheduled for {{planned_start}}."
consumes:
- type: http
baseUri: https://unitedhealth.service-now.com/api/now/v1
authentication:
type: basic
username: $secrets.snow_user
password: $secrets.snow_password
resources:
- path: /table/change_request
operations:
- id: createChangeRequest
method: POST
- type: http
baseUri: https://graph.microsoft.com/v1.0
authentication:
type: bearer
token: $secrets.ms_graph_token
resources:
- path: /teams/messages
operations:
- id: sendTeamsMessage
method: POST
Jira Clinical Platform Backlog Query
▼
project-management clinical jira
Queries the Jira backlog for open clinical platform user stories and their priority rankings.
naftiko: "0.5"
info:
title: Jira Clinical Platform Backlog Query
version: "1.0"
description: Queries the Jira backlog for open clinical platform user stories and their priority rankings.
tags: [project-management, clinical, jira]
capability:
exposes:
type: mcp
port: 8080
tools:
- name: query_clinical_backlog
description: Returns a list of open backlog items for the clinical platform team filtered by priority.
inputParameters:
- name: project_key
in: query
required: true
type: string
- name: priority
in: query
required: true
type: string
call:
operationId: searchIssues
input:
jql: "project={{project_key}} AND priority={{priority}} AND status=Open"
maxResults: "50"
outputParameters:
- name: issues
type: array
- name: total
type: integer
consumes:
- type: http
baseUri: https://unitedhealth.atlassian.net/rest/api/3
authentication:
type: basic
username: $secrets.jira_user
password: $secrets.jira_api_token
resources:
- path: /search
operations:
- id: searchIssues
method: GET
Jira Engineering Sprint Velocity Report
▼
devops agile communication
Queries Jira for completed sprint stories and posts velocity metrics to the Engineering Teams channel.
naftiko: "0.5"
info:
title: Jira Engineering Sprint Velocity Report
version: "1.0"
description: Queries Jira for completed sprint stories and posts velocity metrics to the Engineering Teams channel.
tags: [devops, agile, communication]
capability:
exposes:
type: mcp
port: 8080
tools:
- name: get_sprint_velocity
description: Fetches sprint completion data and posts velocity metrics.
inputParameters:
- name: board_id
in: query
required: true
type: string
- name: sprint_id
in: query
required: true
type: string
steps:
- name: get-sprint-data
call:
operationId: getSprintReport
input:
boardId: "{{board_id}}"
sprintId: "{{sprint_id}}"
- name: post-velocity
call:
operationId: sendTeamsMessage
input:
channelId: engineering-metrics
message: "Sprint {{sprint_id}} velocity: {{get-sprint-data.completed_points}} points completed out of {{get-sprint-data.committed_points}} committed."
consumes:
- type: http
baseUri: https://unitedhealth.atlassian.net/rest/agile/1.0
authentication:
type: basic
username: $secrets.jira_user
password: $secrets.jira_token
resources:
- path: /board/{boardId}/sprint/{sprintId}/report
operations:
- id: getSprintReport
method: GET
- type: http
baseUri: https://graph.microsoft.com/v1.0
authentication:
type: bearer
token: $secrets.ms_graph_token
resources:
- path: /teams/messages
operations:
- id: sendTeamsMessage
method: POST
Medicaid Eligibility Redetermination
▼
enrollment medicaid healthcare
Processes Medicaid eligibility redetermination by verifying member data, submitting to the state system, and updating enrollment status.
naftiko: "0.5"
info:
title: Medicaid Eligibility Redetermination
version: "1.0"
description: Processes Medicaid eligibility redetermination by verifying member data, submitting to the state system, and updating enrollment status.
tags: [enrollment, medicaid, healthcare]
capability:
exposes:
type: mcp
port: 8080
tools:
- name: process_redetermination
description: Validates member demographics, submits redetermination, and updates enrollment records.
inputParameters:
- name: member_id
in: body
required: true
type: string
- name: state
in: body
required: true
type: string
steps:
- name: validate-demographics
call:
operationId: getMemberDemographics
input:
memberId: "{{member_id}}"
- name: submit-redetermination
call:
operationId: submitRedetermination
input:
memberId: "{{member_id}}"
state: "{{state}}"
demographics: "{{validate-demographics.data}}"
- name: update-enrollment
call:
operationId: updateEnrollment
input:
memberId: "{{member_id}}"
redeterminationStatus: "{{submit-redetermination.status}}"
effectiveDate: "{{submit-redetermination.effective_date}}"
consumes:
- type: http
baseUri: https://api.uhc.com/member-services/v1
authentication:
type: bearer
token: $secrets.uhc_member_token
resources:
- path: /members/{memberId}/demographics
operations:
- id: getMemberDemographics
method: GET
- type: http
baseUri: https://api.uhc.com/medicaid/v1
authentication:
type: bearer
token: $secrets.uhc_medicaid_token
resources:
- path: /redeterminations
operations:
- id: submitRedetermination
method: POST
- type: http
baseUri: https://api.uhc.com/enrollment/v1
authentication:
type: bearer
token: $secrets.uhc_enrollment_token
resources:
- path: /members/{memberId}
operations:
- id: updateEnrollment
method: PUT
Medicare Star Rating Improvement Tracker
▼
population-health medicare healthcare jira
Tracks star rating performance metrics, identifies low-performing measures, and creates improvement action items in Jira.
naftiko: "0.5"
info:
title: Medicare Star Rating Improvement Tracker
version: "1.0"
description: Tracks star rating performance metrics, identifies low-performing measures, and creates improvement action items in Jira.
tags: [population-health, medicare, healthcare, jira]
capability:
exposes:
type: mcp
port: 8080
tools:
- name: track_star_ratings
description: Queries star rating data, identifies gaps below target, and creates Jira improvement stories.
inputParameters:
- name: contract_id
in: body
required: true
type: string
- name: target_rating
in: body
required: true
type: number
steps:
- name: query-ratings
call:
operationId: executeQuery
input:
statement: "SELECT measure_id, current_score, target_score FROM star_ratings WHERE contract='{{contract_id}}' AND current_score < {{target_rating}}"
- name: create-stories
call:
operationId: createIssue
input:
project: "STARS"
issuetype: "Story"
summary: "Improve star measure for contract {{contract_id}}"
priority: "High"
consumes:
- type: http
baseUri: https://uhc-analytics.snowflakecomputing.com/api/v2
authentication:
type: bearer
token: $secrets.snowflake_token
resources:
- path: /statements
operations:
- id: executeQuery
method: POST
- type: http
baseUri: https://unitedhealth.atlassian.net/rest/api/3
authentication:
type: basic
username: $secrets.jira_user
password: $secrets.jira_api_token
resources:
- path: /issue
operations:
- id: createIssue
method: POST
Member Claims Status Lookup
▼
claims member-services healthcare
Retrieves health insurance claim status for a UnitedHealthcare member from the claims platform.
naftiko: "0.5"
info:
title: Member Claims Status Lookup
version: "1.0"
description: Retrieves health insurance claim status for a UnitedHealthcare member from the claims platform.
tags: [claims, member-services, healthcare]
capability:
exposes:
type: mcp
port: 8080
tools:
- name: get_claim_status
description: Returns the current status and adjudication details for a member claim.
inputParameters:
- name: claim_id
in: query
required: true
type: string
- name: member_id
in: query
required: true
type: string
call:
operationId: getClaimStatus
input:
claimId: "{{claim_id}}"
memberId: "{{member_id}}"
outputParameters:
- name: status
type: string
- name: adjudication_date
type: string
- name: allowed_amount
type: number
consumes:
- type: http
baseUri: https://api.uhc.com/claims/v2
authentication:
type: bearer
token: $secrets.uhc_claims_token
resources:
- path: /claims/{claimId}
operations:
- id: getClaimStatus
method: GET
Member Discharge Follow Up Orchestrator
▼
clinical population-health healthcare
Triggers post-discharge follow-up protocols including medication reconciliation, PCP appointment scheduling, and care coordinator notification.
naftiko: "0.5"
info:
title: Member Discharge Follow-Up Orchestrator
version: "1.0"
description: Triggers post-discharge follow-up protocols including medication reconciliation, PCP appointment scheduling, and care coordinator notification.
tags: [clinical, population-health, healthcare]
capability:
exposes:
type: mcp
port: 8080
tools:
- name: process_discharge_followup
description: Retrieves discharge info, schedules follow-up, and triggers medication reconciliation.
inputParameters:
- name: member_id
in: body
required: true
type: string
- name: discharge_id
in: body
required: true
type: string
steps:
- name: get-discharge
call:
operationId: getDischargeInfo
input:
dischargeId: "{{discharge_id}}"
- name: schedule-followup
call:
operationId: scheduleAppointment
input:
memberId: "{{member_id}}"
appointmentType: "post_discharge"
withinDays: "7"
diagnosis: "{{get-discharge.primary_diagnosis}}"
- name: trigger-med-recon
call:
operationId: createMedReconciliation
input:
memberId: "{{member_id}}"
dischargeMeds: "{{get-discharge.medications}}"
dischargeDate: "{{get-discharge.discharge_date}}"
consumes:
- type: http
baseUri: https://api.uhc.com/clinical/v1
authentication:
type: bearer
token: $secrets.uhc_clinical_token
resources:
- path: /discharges/{dischargeId}
operations:
- id: getDischargeInfo
method: GET
- type: http
baseUri: https://api.uhc.com/scheduling/v1
authentication:
type: bearer
token: $secrets.uhc_scheduling_token
resources:
- path: /appointments
operations:
- id: scheduleAppointment
method: POST
- type: http
baseUri: https://api.optum.com/rx/v1
authentication:
type: bearer
token: $secrets.optum_rx_token
resources:
- path: /medication-reconciliation
operations:
- id: createMedReconciliation
method: POST
Member Eligibility Verification
▼
claims member-services healthcare
Verifies a UnitedHealthcare member's eligibility and benefit coverage for a specified date of service.
naftiko: "0.5"
info:
title: Member Eligibility Verification
version: "1.0"
description: Verifies a UnitedHealthcare member's eligibility and benefit coverage for a specified date of service.
tags: [claims, member-services, healthcare]
capability:
exposes:
type: mcp
port: 8080
tools:
- name: verify_member_eligibility
description: Returns eligibility status and benefit summary for a member on a given service date.
inputParameters:
- name: member_id
in: query
required: true
type: string
- name: service_date
in: query
required: true
type: string
call:
operationId: verifyEligibility
input:
memberId: "{{member_id}}"
serviceDate: "{{service_date}}"
outputParameters:
- name: eligible
type: boolean
- name: plan_name
type: string
- name: copay_amount
type: number
consumes:
- type: http
baseUri: https://api.uhc.com/eligibility/v2
authentication:
type: bearer
token: $secrets.uhc_eligibility_token
resources:
- path: /members/{memberId}/eligibility
operations:
- id: verifyEligibility
method: GET
Member Enrollment Change Orchestrator
▼
enrollment member-services healthcare
Processes a member plan change request by validating eligibility, updating the enrollment system, and notifying downstream systems.
naftiko: "0.5"
info:
title: Member Enrollment Change Orchestrator
version: "1.0"
description: Processes a member plan change request by validating eligibility, updating the enrollment system, and notifying downstream systems.
tags: [enrollment, member-services, healthcare]
capability:
exposes:
type: mcp
port: 8080
tools:
- name: process_enrollment_change
description: Validates eligibility, submits plan change, and synchronizes with pharmacy and claims systems.
inputParameters:
- name: member_id
in: body
required: true
type: string
- name: new_plan_id
in: body
required: true
type: string
- name: effective_date
in: body
required: true
type: string
steps:
- name: validate-eligibility
call:
operationId: verifyEligibility
input:
memberId: "{{member_id}}"
serviceDate: "{{effective_date}}"
- name: submit-plan-change
call:
operationId: changePlan
input:
memberId: "{{member_id}}"
newPlanId: "{{new_plan_id}}"
effectiveDate: "{{effective_date}}"
- name: sync-pharmacy
call:
operationId: updatePharmacyBenefit
input:
memberId: "{{member_id}}"
planId: "{{new_plan_id}}"
effectiveDate: "{{effective_date}}"
consumes:
- type: http
baseUri: https://api.uhc.com/eligibility/v2
authentication:
type: bearer
token: $secrets.uhc_eligibility_token
resources:
- path: /members/{memberId}/eligibility
operations:
- id: verifyEligibility
method: GET
- type: http
baseUri: https://api.uhc.com/enrollment/v1
authentication:
type: bearer
token: $secrets.uhc_enrollment_token
resources:
- path: /members/{memberId}/plan-change
operations:
- id: changePlan
method: POST
- type: http
baseUri: https://api.optum.com/rx/v1
authentication:
type: bearer
token: $secrets.optum_rx_token
resources:
- path: /members/{memberId}/pharmacy-benefit
operations:
- id: updatePharmacyBenefit
method: PUT
Member Grievance Tracking Workflow
▼
member-services itsm healthcare
Logs a member grievance in ServiceNow, assigns to a resolution specialist, and tracks SLA compliance.
naftiko: "0.5"
info:
title: Member Grievance Tracking Workflow
version: "1.0"
description: Logs a member grievance in ServiceNow, assigns to a resolution specialist, and tracks SLA compliance.
tags: [member-services, itsm, healthcare]
capability:
exposes:
type: mcp
port: 8080
tools:
- name: log_grievance
description: Creates a grievance case, assigns the specialist, and sets SLA monitoring in ServiceNow.
inputParameters:
- name: member_id
in: body
required: true
type: string
- name: grievance_type
in: body
required: true
type: string
- name: description
in: body
required: true
type: string
steps:
- name: create-case
call:
operationId: createIncident
input:
short_description: "Member grievance — {{grievance_type}}"
description: "Member {{member_id}}: {{description}}"
category: "grievance"
urgency: "2"
- name: assign-specialist
call:
operationId: updateIncident
input:
sys_id: "{{create-case.sys_id}}"
assigned_to: "grievance-resolution-team"
- name: notify-team
call:
operationId: sendTeamsMessage
input:
channelId: "grievance-team"
message: "New grievance {{create-case.number}} for member {{member_id}} — {{grievance_type}}. SLA: 30 days."
consumes:
- type: http
baseUri: https://unitedhealth.service-now.com/api/now/v1
authentication:
type: basic
username: $secrets.snow_user
password: $secrets.snow_password
resources:
- path: /table/incident
operations:
- id: createIncident
method: POST
- type: http
baseUri: https://unitedhealth.service-now.com/api/now/v1
authentication:
type: basic
username: $secrets.snow_user
password: $secrets.snow_password
resources:
- path: /table/incident/{sys_id}
operations:
- id: updateIncident
method: PATCH
- type: http
baseUri: https://graph.microsoft.com/v1.0
authentication:
type: bearer
token: $secrets.ms_graph_token
resources:
- path: /teams/messages
operations:
- id: sendTeamsMessage
method: POST
Member Hra Completion Tracker
▼
population-health member-services healthcare
Tracks health risk assessment completion rates and triggers reminder campaigns for incomplete HRAs.
naftiko: "0.5"
info:
title: Member HRA Completion Tracker
version: "1.0"
description: Tracks health risk assessment completion rates and triggers reminder campaigns for incomplete HRAs.
tags: [population-health, member-services, healthcare]
capability:
exposes:
type: mcp
port: 8080
tools:
- name: track_hra_completion
description: Queries HRA completion data, identifies non-completers, and triggers outreach reminders.
inputParameters:
- name: plan_year
in: body
required: true
type: string
- name: group_id
in: body
required: true
type: string
steps:
- name: query-completion
call:
operationId: executeQuery
input:
statement: "SELECT member_id, hra_status FROM hra_tracking WHERE plan_year='{{plan_year}}' AND group_id='{{group_id}}' AND hra_status='incomplete'"
- name: trigger-reminders
call:
operationId: createCampaign
input:
name: "HRA Reminder — {{group_id}} — {{plan_year}}"
type: "hra_reminder"
- name: notify-account-team
call:
operationId: sendTeamsMessage
input:
channelId: "account-management"
message: "HRA reminder campaign launched for group {{group_id}}."
consumes:
- type: http
baseUri: https://uhc-analytics.snowflakecomputing.com/api/v2
authentication:
type: bearer
token: $secrets.snowflake_token
resources:
- path: /statements
operations:
- id: executeQuery
method: POST
- type: http
baseUri: https://unitedhealth.my.salesforce.com/services/data/v58.0
authentication:
type: bearer
token: $secrets.salesforce_token
resources:
- path: /sobjects/Campaign
operations:
- id: createCampaign
method: POST
- type: http
baseUri: https://graph.microsoft.com/v1.0
authentication:
type: bearer
token: $secrets.ms_graph_token
resources:
- path: /teams/messages
operations:
- id: sendTeamsMessage
method: POST
Member Id Card Reissue Workflow
▼
enrollment member-services healthcare
Processes a member ID card reissue request by validating enrollment, generating a new card, and mailing notification.
naftiko: "0.5"
info:
title: Member ID Card Reissue Workflow
version: "1.0"
description: Processes a member ID card reissue request by validating enrollment, generating a new card, and mailing notification.
tags: [enrollment, member-services, healthcare]
capability:
exposes:
type: mcp
port: 8080
tools:
- name: reissue_id_card
description: Validates member enrollment, triggers card generation, and sends confirmation email.
inputParameters:
- name: member_id
in: body
required: true
type: string
- name: reason
in: body
required: true
type: string
steps:
- name: validate-enrollment
call:
operationId: verifyEligibility
input:
memberId: "{{member_id}}"
serviceDate: "2026-03-27"
- name: generate-card
call:
operationId: requestIdCard
input:
memberId: "{{member_id}}"
reason: "{{reason}}"
- name: send-confirmation
call:
operationId: sendEmail
input:
to: "{{member_id}}@uhc-member-portal.com"
subject: "ID Card Reissue Confirmation"
body: "Your new ID card has been requested. Card number: {{generate-card.card_number}}. Expected delivery: 7-10 business days."
consumes:
- type: http
baseUri: https://api.uhc.com/eligibility/v2
authentication:
type: bearer
token: $secrets.uhc_eligibility_token
resources:
- path: /members/{memberId}/eligibility
operations:
- id: verifyEligibility
method: GET
- type: http
baseUri: https://api.uhc.com/member-services/v1
authentication:
type: bearer
token: $secrets.uhc_member_token
resources:
- path: /id-cards
operations:
- id: requestIdCard
method: POST
- type: http
baseUri: https://graph.microsoft.com/v1.0
authentication:
type: bearer
token: $secrets.ms_graph_token
resources:
- path: /me/sendMail
operations:
- id: sendEmail
method: POST
Member Pcp Assignment Workflow
▼
enrollment provider-network healthcare
Assigns or changes a member's primary care physician and updates enrollment and care management records.
naftiko: "0.5"
info:
title: Member PCP Assignment Workflow
version: "1.0"
description: Assigns or changes a member's primary care physician and updates enrollment and care management records.
tags: [enrollment, provider-network, healthcare]
capability:
exposes:
type: mcp
port: 8080
tools:
- name: assign_pcp
description: Validates provider availability, updates PCP assignment, and notifies care management.
inputParameters:
- name: member_id
in: body
required: true
type: string
- name: provider_npi
in: body
required: true
type: string
steps:
- name: validate-provider
call:
operationId: getProviderDetails
input:
providerNpi: "{{provider_npi}}"
- name: update-assignment
call:
operationId: assignPCP
input:
memberId: "{{member_id}}"
providerNpi: "{{provider_npi}}"
providerName: "{{validate-provider.name}}"
- name: notify-care-team
call:
operationId: sendTeamsMessage
input:
channelId: "care-coordination"
message: "PCP assignment updated for member {{member_id}} to {{validate-provider.name}} (NPI: {{provider_npi}})."
consumes:
- type: http
baseUri: https://api.uhc.com/provider-directory/v2
authentication:
type: bearer
token: $secrets.uhc_provider_token
resources:
- path: /providers/{providerNpi}
operations:
- id: getProviderDetails
method: GET
- type: http
baseUri: https://api.uhc.com/enrollment/v1
authentication:
type: bearer
token: $secrets.uhc_enrollment_token
resources:
- path: /members/{memberId}/pcp
operations:
- id: assignPCP
method: PUT
- type: http
baseUri: https://graph.microsoft.com/v1.0
authentication:
type: bearer
token: $secrets.ms_graph_token
resources:
- path: /teams/messages
operations:
- id: sendTeamsMessage
method: POST
Member Risk Score Dashboard Refresh
▼
population-health analytics healthcare power-bi
Refreshes the population health risk score dashboard by querying updated scores from Snowflake and pushing to Power BI.
naftiko: "0.5"
info:
title: Member Risk Score Dashboard Refresh
version: "1.0"
description: Refreshes the population health risk score dashboard by querying updated scores from Snowflake and pushing to Power BI.
tags: [population-health, analytics, healthcare, power-bi]
capability:
exposes:
type: mcp
port: 8080
tools:
- name: refresh_risk_dashboard
description: Queries latest risk scores, triggers dashboard refresh, and notifies the analytics team.
inputParameters:
- name: cohort
in: body
required: true
type: string
- name: workspace_id
in: body
required: true
type: string
steps:
- name: query-scores
call:
operationId: executeQuery
input:
statement: "SELECT member_id, risk_score, risk_category, last_updated FROM risk_scores WHERE cohort='{{cohort}}' ORDER BY risk_score DESC"
- name: refresh-dashboard
call:
operationId: refreshDataset
input:
datasetId: "risk-scores"
workspaceId: "{{workspace_id}}"
- name: notify-team
call:
operationId: sendTeamsMessage
input:
channelId: "population-health-analytics"
message: "Risk score dashboard refreshed for cohort {{cohort}}."
consumes:
- type: http
baseUri: https://uhc-analytics.snowflakecomputing.com/api/v2
authentication:
type: bearer
token: $secrets.snowflake_token
resources:
- path: /statements
operations:
- id: executeQuery
method: POST
- type: http
baseUri: https://api.powerbi.com/v1.0/myorg
authentication:
type: bearer
token: $secrets.powerbi_token
resources:
- path: /groups/{workspaceId}/datasets/risk-scores/refreshes
operations:
- id: refreshDataset
method: POST
- type: http
baseUri: https://graph.microsoft.com/v1.0
authentication:
type: bearer
token: $secrets.ms_graph_token
resources:
- path: /teams/messages
operations:
- id: sendTeamsMessage
method: POST
Member Satisfaction Survey Analysis
▼
population-health analytics healthcare confluence
Aggregates member satisfaction survey responses from Snowflake, calculates NPS scores, and publishes insights to Confluence.
naftiko: "0.5"
info:
title: Member Satisfaction Survey Analysis
version: "1.0"
description: Aggregates member satisfaction survey responses from Snowflake, calculates NPS scores, and publishes insights to Confluence.
tags: [population-health, analytics, healthcare, confluence]
capability:
exposes:
type: mcp
port: 8080
tools:
- name: analyze_satisfaction_surveys
description: Queries survey data, calculates satisfaction metrics, and publishes an analysis report.
inputParameters:
- name: survey_period
in: body
required: true
type: string
- name: region
in: body
required: true
type: string
steps:
- name: query-surveys
call:
operationId: executeQuery
input:
statement: "SELECT question_id, avg_score, nps, response_count FROM survey_results WHERE period='{{survey_period}}' AND region='{{region}}'"
- name: publish-report
call:
operationId: createContent
input:
type: "page"
title: "Member Satisfaction Report — {{survey_period}} — {{region}}"
space: "QUALITY"
body: "{{query-surveys.results}}"
consumes:
- type: http
baseUri: https://uhc-analytics.snowflakecomputing.com/api/v2
authentication:
type: bearer
token: $secrets.snowflake_token
resources:
- path: /statements
operations:
- id: executeQuery
method: POST
- type: http
baseUri: https://unitedhealth.atlassian.net/wiki/rest/api
authentication:
type: basic
username: $secrets.confluence_user
password: $secrets.confluence_api_token
resources:
- path: /content
operations:
- id: createContent
method: POST
Member Wellness Program Enrollment
▼
population-health wellness healthcare salesforce
Enrolls a member in a Rally Health wellness program and creates a care plan with milestone tracking in Salesforce.
naftiko: "0.5"
info:
title: Member Wellness Program Enrollment
version: "1.0"
description: Enrolls a member in a Rally Health wellness program and creates a care plan with milestone tracking in Salesforce.
tags: [population-health, wellness, healthcare, salesforce]
capability:
exposes:
type: mcp
port: 8080
tools:
- name: enroll_wellness_program
description: Enrolls the member in Rally, creates a care plan, and sets up milestone tracking.
inputParameters:
- name: member_id
in: body
required: true
type: string
- name: program_id
in: body
required: true
type: string
steps:
- name: enroll-member
call:
operationId: enrollProgram
input:
memberId: "{{member_id}}"
programId: "{{program_id}}"
- name: create-care-plan
call:
operationId: createCarePlan
input:
memberId: "{{member_id}}"
programId: "{{program_id}}"
enrollmentId: "{{enroll-member.enrollment_id}}"
- name: notify-member
call:
operationId: sendTeamsMessage
input:
channelId: "member-wellness"
message: "Member {{member_id}} enrolled in wellness program {{program_id}}. Care plan created."
consumes:
- type: http
baseUri: https://api.rallyhealth.com/v1
authentication:
type: bearer
token: $secrets.rally_health_token
resources:
- path: /programs/{programId}/enroll
operations:
- id: enrollProgram
method: POST
- type: http
baseUri: https://unitedhealth.my.salesforce.com/services/data/v58.0
authentication:
type: bearer
token: $secrets.salesforce_token
resources:
- path: /sobjects/CarePlan__c
operations:
- id: createCarePlan
method: POST
- type: http
baseUri: https://graph.microsoft.com/v1.0
authentication:
type: bearer
token: $secrets.ms_graph_token
resources:
- path: /teams/messages
operations:
- id: sendTeamsMessage
method: POST
Network Adequacy Analysis Pipeline
▼
provider-network analytics healthcare jira
Analyzes provider network adequacy by geography, identifies gaps, and creates remediation tasks in Jira.
naftiko: "0.5"
info:
title: Network Adequacy Analysis Pipeline
version: "1.0"
description: Analyzes provider network adequacy by geography, identifies gaps, and creates remediation tasks in Jira.
tags: [provider-network, analytics, healthcare, jira]
capability:
exposes:
type: mcp
port: 8080
tools:
- name: analyze_network_adequacy
description: Queries provider distribution, identifies adequacy gaps, and creates Jira stories for remediation.
inputParameters:
- name: state
in: body
required: true
type: string
- name: specialty
in: body
required: true
type: string
steps:
- name: query-network
call:
operationId: executeQuery
input:
statement: "SELECT county, provider_count, member_count, ratio FROM network_adequacy WHERE state='{{state}}' AND specialty='{{specialty}}'"
- name: create-stories
call:
operationId: createIssue
input:
project: "NETWORK"
issuetype: "Story"
summary: "Network adequacy gap: {{specialty}} in {{state}}"
priority: "High"
consumes:
- type: http
baseUri: https://uhc-analytics.snowflakecomputing.com/api/v2
authentication:
type: bearer
token: $secrets.snowflake_token
resources:
- path: /statements
operations:
- id: executeQuery
method: POST
- type: http
baseUri: https://unitedhealth.atlassian.net/rest/api/3
authentication:
type: basic
username: $secrets.jira_user
password: $secrets.jira_api_token
resources:
- path: /issue
operations:
- id: createIssue
method: POST
Okta Application Access Provisioning
▼
identity hr security
Assigns or removes an Okta application entitlement for an employee based on a role change request from Workday.
naftiko: "0.5"
info:
title: Okta Application Access Provisioning
version: "1.0"
description: Assigns or removes an Okta application entitlement for an employee based on a role change request from Workday.
tags: [identity, hr, security]
capability:
exposes:
type: mcp
port: 8080
tools:
- name: provision_app_access
description: Assigns or revokes an Okta application entitlement for a given employee.
inputParameters:
- name: employee_id
in: body
required: true
type: string
- name: app_id
in: body
required: true
type: string
- name: action
in: body
required: true
type: string
call:
operationId: assignOktaApp
input:
userId: "{{employee_id}}"
appId: "{{app_id}}"
action: "{{action}}"
outputParameters:
- name: assignment_id
type: string
- name: status
type: string
consumes:
- type: http
baseUri: https://unitedhealth.okta.com/api/v1
authentication:
type: bearer
token: $secrets.okta_token
resources:
- path: /apps/{appId}/users
operations:
- id: assignOktaApp
method: POST
Okta Clinical Access Provisioning
▼
identity-management clinical okta healthcare
Provisions clinical application access through Okta based on role assignments from Workday and logs the activity.
naftiko: "0.5"
info:
title: Okta Clinical Access Provisioning
version: "1.0"
description: Provisions clinical application access through Okta based on role assignments from Workday and logs the activity.
tags: [identity-management, clinical, okta, healthcare]
capability:
exposes:
type: mcp
port: 8080
tools:
- name: provision_clinical_access
description: Retrieves role from Workday, provisions Okta applications, and logs provisioning activity.
inputParameters:
- name: employee_id
in: body
required: true
type: string
- name: application_id
in: body
required: true
type: string
steps:
- name: get-role
call:
operationId: getWorkerRole
input:
employeeId: "{{employee_id}}"
- name: provision-app
call:
operationId: assignApplication
input:
userId: "{{employee_id}}"
applicationId: "{{application_id}}"
role: "{{get-role.role}}"
- name: log-activity
call:
operationId: createIncident
input:
short_description: "Clinical access provisioned: {{employee_id}} -> {{application_id}}"
category: "access_management"
urgency: "4"
consumes:
- type: http
baseUri: https://wd5-impl-services1.workday.com/ccx/api/v1/unitedhealth
authentication:
type: bearer
token: $secrets.workday_token
resources:
- path: /workers/{employeeId}
operations:
- id: getWorkerRole
method: GET
- type: http
baseUri: https://unitedhealth.okta.com/api/v1
authentication:
type: bearer
token: $secrets.okta_token
resources:
- path: /apps/{applicationId}/users
operations:
- id: assignApplication
method: PUT
- type: http
baseUri: https://unitedhealth.service-now.com/api/now/v1
authentication:
type: basic
username: $secrets.snow_user
password: $secrets.snow_password
resources:
- path: /table/incident
operations:
- id: createIncident
method: POST
Optum Behavioral Health Referral Lookup
▼
clinical behavioral-health healthcare
Retrieves behavioral health referral status and authorized sessions from Optum Behavioral Health.
naftiko: "0.5"
info:
title: Optum Behavioral Health Referral Lookup
version: "1.0"
description: Retrieves behavioral health referral status and authorized sessions from Optum Behavioral Health.
tags: [clinical, behavioral-health, healthcare]
capability:
exposes:
type: mcp
port: 8080
tools:
- name: get_bh_referral
description: Returns referral authorization details including approved sessions and expiration date.
inputParameters:
- name: referral_id
in: query
required: true
type: string
call:
operationId: getBHReferral
input:
referralId: "{{referral_id}}"
outputParameters:
- name: status
type: string
- name: approved_sessions
type: integer
- name: used_sessions
type: integer
- name: expiration_date
type: string
consumes:
- type: http
baseUri: https://api.optum.com/behavioral-health/v1
authentication:
type: bearer
token: $secrets.optum_bh_token
resources:
- path: /referrals/{referralId}
operations:
- id: getBHReferral
method: GET
Optum Care Gap Status
▼
population-health clinical healthcare
Retrieves open care gaps for a member from the Optum population health analytics platform.
naftiko: "0.5"
info:
title: Optum Care Gap Status
version: "1.0"
description: Retrieves open care gaps for a member from the Optum population health analytics platform.
tags: [population-health, clinical, healthcare]
capability:
exposes:
type: mcp
port: 8080
tools:
- name: get_care_gaps
description: Returns a list of open care gaps with measure names, due dates, and compliance status.
inputParameters:
- name: member_id
in: query
required: true
type: string
call:
operationId: getCareGaps
input:
memberId: "{{member_id}}"
outputParameters:
- name: care_gaps
type: array
- name: total_open
type: integer
consumes:
- type: http
baseUri: https://api.optum.com/population-health/v1
authentication:
type: bearer
token: $secrets.optum_ph_token
resources:
- path: /members/{memberId}/care-gaps
operations:
- id: getCareGaps
method: GET
Optum Care Management Case Creation
▼
clinical population-health healthcare
Creates a care management case for high-risk members identified through analytics, assigns a care manager, and notifies the team.
naftiko: "0.5"
info:
title: Optum Care Management Case Creation
version: "1.0"
description: Creates a care management case for high-risk members identified through analytics, assigns a care manager, and notifies the team.
tags: [clinical, population-health, healthcare]
capability:
exposes:
type: mcp
port: 8080
tools:
- name: create_care_case
description: Identifies the member's risk profile, creates a care management case, and assigns a care manager.
inputParameters:
- name: member_id
in: body
required: true
type: string
- name: risk_category
in: body
required: true
type: string
steps:
- name: get-risk-profile
call:
operationId: getRiskProfile
input:
memberId: "{{member_id}}"
- name: create-case
call:
operationId: createCareCase
input:
memberId: "{{member_id}}"
riskCategory: "{{risk_category}}"
riskScore: "{{get-risk-profile.risk_score}}"
conditions: "{{get-risk-profile.conditions}}"
- name: notify-care-manager
call:
operationId: sendTeamsMessage
input:
channelId: "care-management"
message: "New care case {{create-case.case_id}} created for member {{member_id}} — risk: {{risk_category}}."
consumes:
- type: http
baseUri: https://api.optum.com/population-health/v1
authentication:
type: bearer
token: $secrets.optum_ph_token
resources:
- path: /members/{memberId}/risk-profile
operations:
- id: getRiskProfile
method: GET
- type: http
baseUri: https://api.optum.com/care-management/v1
authentication:
type: bearer
token: $secrets.optum_cm_token
resources:
- path: /cases
operations:
- id: createCareCase
method: POST
- type: http
baseUri: https://graph.microsoft.com/v1.0
authentication:
type: bearer
token: $secrets.ms_graph_token
resources:
- path: /teams/messages
operations:
- id: sendTeamsMessage
method: POST
Optum Financial Claims Summary
▼
claims healthcare optum-financial
Retrieves a financial summary of claims paid through Optum Financial including HSA and HRA spend.
naftiko: "0.5"
info:
title: Optum Financial Claims Summary
version: "1.0"
description: Retrieves a financial summary of claims paid through Optum Financial including HSA and HRA spend.
tags: [claims, healthcare, optum-financial]
capability:
exposes:
type: mcp
port: 8080
tools:
- name: get_claims_financial_summary
description: Returns total claims paid, HSA disbursements, and HRA reimbursements for the specified period.
inputParameters:
- name: member_id
in: query
required: true
type: string
- name: year
in: query
required: true
type: string
call:
operationId: getClaimsFinancialSummary
input:
memberId: "{{member_id}}"
year: "{{year}}"
outputParameters:
- name: total_claims_paid
type: number
- name: hsa_disbursed
type: number
- name: hra_reimbursed
type: number
consumes:
- type: http
baseUri: https://api.optum.com/financial/v1
authentication:
type: bearer
token: $secrets.optum_financial_token
resources:
- path: /members/{memberId}/claims-summary
operations:
- id: getClaimsFinancialSummary
method: GET
Optum Rx Formulary Lookup
▼
pharmacy formulary healthcare
Searches the Optum Rx drug formulary for coverage tier and quantity limits for a given NDC code.
naftiko: "0.5"
info:
title: Optum Rx Formulary Lookup
version: "1.0"
description: Searches the Optum Rx drug formulary for coverage tier and quantity limits for a given NDC code.
tags: [pharmacy, formulary, healthcare]
capability:
exposes:
type: mcp
port: 8080
tools:
- name: lookup_formulary
description: Returns formulary tier, quantity limit, and step therapy requirements for a drug.
inputParameters:
- name: ndc_code
in: query
required: true
type: string
- name: plan_id
in: query
required: true
type: string
call:
operationId: getFormularyEntry
input:
ndcCode: "{{ndc_code}}"
planId: "{{plan_id}}"
outputParameters:
- name: tier
type: string
- name: quantity_limit
type: integer
- name: step_therapy_required
type: boolean
consumes:
- type: http
baseUri: https://api.optum.com/rx/formulary/v1
authentication:
type: bearer
token: $secrets.optum_rx_token
resources:
- path: /formulary/{ndcCode}
operations:
- id: getFormularyEntry
method: GET
Optum Rx Medication History
▼
pharmacy member-services healthcare
Retrieves prescription medication fill history for a member from the Optum Rx pharmacy system.
naftiko: "0.5"
info:
title: Optum Rx Medication History
version: "1.0"
description: Retrieves prescription medication fill history for a member from the Optum Rx pharmacy system.
tags: [pharmacy, member-services, healthcare]
capability:
exposes:
type: mcp
port: 8080
tools:
- name: get_medication_history
description: Returns a chronological list of medication fills including drug name, fill date, and pharmacy.
inputParameters:
- name: member_id
in: query
required: true
type: string
- name: months_back
in: query
required: true
type: integer
call:
operationId: getMedicationHistory
input:
memberId: "{{member_id}}"
monthsBack: "{{months_back}}"
outputParameters:
- name: medications
type: array
- name: total_fills
type: integer
consumes:
- type: http
baseUri: https://api.optum.com/rx/v1
authentication:
type: bearer
token: $secrets.optum_rx_token
resources:
- path: /members/{memberId}/medication-history
operations:
- id: getMedicationHistory
method: GET
Optum Rx Prior Authorization Workflow
▼
pharmacy prior-auth healthcare communication
Submits a prior authorization request for a prescription drug through Optum Rx and notifies the prescriber via Teams.
naftiko: "0.5"
info:
title: Optum Rx Prior Authorization Workflow
version: "1.0"
description: Submits a prior authorization request for a prescription drug through Optum Rx and notifies the prescriber via Teams.
tags: [pharmacy, prior-auth, healthcare, communication]
capability:
exposes:
type: mcp
port: 8080
tools:
- name: submit_prior_auth
description: Creates a prior authorization request and sends notification to the prescriber's channel.
inputParameters:
- name: member_id
in: body
required: true
type: string
- name: drug_code
in: body
required: true
type: string
- name: prescriber_npi
in: body
required: true
type: string
steps:
- name: submit-auth-request
call:
operationId: createPriorAuth
input:
memberId: "{{member_id}}"
drugCode: "{{drug_code}}"
prescriberNpi: "{{prescriber_npi}}"
- name: notify-prescriber
call:
operationId: sendTeamsMessage
input:
channelId: optum-rx-alerts
message: "Prior auth {{submit-auth-request.auth_id}} submitted for member {{member_id}} — drug {{drug_code}}."
consumes:
- type: http
baseUri: https://api.optum.com/rx/v1
authentication:
type: bearer
token: $secrets.optum_rx_token
resources:
- path: /prior-authorizations
operations:
- id: createPriorAuth
method: POST
- type: http
baseUri: https://graph.microsoft.com/v1.0
authentication:
type: bearer
token: $secrets.ms_graph_token
resources:
- path: /teams/messages
operations:
- id: sendTeamsMessage
method: POST
Optum Rx Specialty Drug Coordination
▼
pharmacy clinical healthcare
Coordinates specialty drug dispensing by verifying insurance coverage, checking clinical criteria, and scheduling delivery.
naftiko: "0.5"
info:
title: Optum Rx Specialty Drug Coordination
version: "1.0"
description: Coordinates specialty drug dispensing by verifying insurance coverage, checking clinical criteria, and scheduling delivery.
tags: [pharmacy, clinical, healthcare]
capability:
exposes:
type: mcp
port: 8080
tools:
- name: coordinate_specialty_drug
description: Verifies coverage, validates clinical criteria, and schedules specialty drug delivery.
inputParameters:
- name: member_id
in: body
required: true
type: string
- name: drug_ndc
in: body
required: true
type: string
- name: prescriber_npi
in: body
required: true
type: string
steps:
- name: check-coverage
call:
operationId: checkSpecialtyCoverage
input:
memberId: "{{member_id}}"
drugNdc: "{{drug_ndc}}"
- name: validate-clinical
call:
operationId: validateClinicalCriteria
input:
memberId: "{{member_id}}"
drugNdc: "{{drug_ndc}}"
prescriberNpi: "{{prescriber_npi}}"
- name: schedule-delivery
call:
operationId: scheduleDelivery
input:
memberId: "{{member_id}}"
drugNdc: "{{drug_ndc}}"
coverageApproved: "{{check-coverage.approved}}"
clinicalApproved: "{{validate-clinical.approved}}"
consumes:
- type: http
baseUri: https://api.optum.com/rx/specialty/v1
authentication:
type: bearer
token: $secrets.optum_specialty_token
resources:
- path: /coverage/{memberId}
operations:
- id: checkSpecialtyCoverage
method: GET
- type: http
baseUri: https://api.optum.com/clinical-decision/v1
authentication:
type: bearer
token: $secrets.optum_clinical_token
resources:
- path: /specialty-criteria
operations:
- id: validateClinicalCriteria
method: POST
- type: http
baseUri: https://api.optum.com/rx/specialty/v1
authentication:
type: bearer
token: $secrets.optum_specialty_token
resources:
- path: /deliveries
operations:
- id: scheduleDelivery
method: POST
Payroll Headcount Snapshot
▼
hr finance payroll
Pulls active employee headcount and payroll cost summary from Workday for finance reporting.
naftiko: "0.5"
info:
title: Payroll Headcount Snapshot
version: "1.0"
description: Pulls active employee headcount and payroll cost summary from Workday for finance reporting.
tags: [hr, finance, payroll]
capability:
exposes:
type: mcp
port: 8080
tools:
- name: get_payroll_snapshot
description: Returns current headcount and total payroll cost by business unit.
inputParameters:
- name: period
in: query
required: true
type: string
call:
operationId: getPayrollSnapshot
input:
period: "{{period}}"
outputParameters:
- name: total_headcount
type: integer
- name: total_payroll_cost
type: number
- name: business_units
type: array
consumes:
- type: http
baseUri: https://wd3-impl-services1.workday.com/ccx/service/unitedhealth
authentication:
type: bearer
token: $secrets.workday_token
resources:
- path: /payroll/snapshot
operations:
- id: getPayrollSnapshot
method: GET
Pharmacy Drug Interaction Check And Alert
▼
pharmacy clinical healthcare
Checks a new prescription against the member's medication history for interactions and alerts the pharmacist via ServiceNow.
naftiko: "0.5"
info:
title: Pharmacy Drug Interaction Check and Alert
version: "1.0"
description: Checks a new prescription against the member's medication history for interactions and alerts the pharmacist via ServiceNow.
tags: [pharmacy, clinical, healthcare]
capability:
exposes:
type: mcp
port: 8080
tools:
- name: check_drug_interactions
description: Retrieves medication history, checks for interactions, and creates a pharmacist alert if risks are found.
inputParameters:
- name: member_id
in: body
required: true
type: string
- name: new_drug_ndc
in: body
required: true
type: string
steps:
- name: get-med-history
call:
operationId: getMedicationHistory
input:
memberId: "{{member_id}}"
monthsBack: "12"
- name: check-interactions
call:
operationId: checkInteractions
input:
currentMeds: "{{get-med-history.medications}}"
newDrug: "{{new_drug_ndc}}"
- name: create-alert
call:
operationId: createIncident
input:
short_description: "Drug interaction alert for member {{member_id}} — new drug {{new_drug_ndc}}"
urgency: "2"
category: "pharmacy"
consumes:
- type: http
baseUri: https://api.optum.com/rx/v1
authentication:
type: bearer
token: $secrets.optum_rx_token
resources:
- path: /members/{memberId}/medication-history
operations:
- id: getMedicationHistory
method: GET
- type: http
baseUri: https://api.optum.com/clinical-decision/v1
authentication:
type: bearer
token: $secrets.optum_clinical_token
resources:
- path: /drug-interactions
operations:
- id: checkInteractions
method: POST
- type: http
baseUri: https://unitedhealth.service-now.com/api/now/v1
authentication:
type: basic
username: $secrets.snow_user
password: $secrets.snow_password
resources:
- path: /table/incident
operations:
- id: createIncident
method: POST
Pharmacy Mail Order Fulfillment Tracker
▼
pharmacy member-services healthcare communication
Tracks mail-order prescription fulfillment status and notifies members of shipping updates via Teams.
naftiko: "0.5"
info:
title: Pharmacy Mail Order Fulfillment Tracker
version: "1.0"
description: Tracks mail-order prescription fulfillment status and notifies members of shipping updates via Teams.
tags: [pharmacy, member-services, healthcare, communication]
capability:
exposes:
type: mcp
port: 8080
tools:
- name: track_mail_order
description: Retrieves fulfillment status, checks shipping tracking, and sends member notification.
inputParameters:
- name: order_id
in: body
required: true
type: string
- name: member_id
in: body
required: true
type: string
steps:
- name: get-order-status
call:
operationId: getOrderStatus
input:
orderId: "{{order_id}}"
- name: get-tracking
call:
operationId: getShipmentTracking
input:
trackingNumber: "{{get-order-status.tracking_number}}"
- name: notify-member
call:
operationId: sendTeamsMessage
input:
channelId: "member-notifications"
message: "Order {{order_id}} for member {{member_id}}: {{get-tracking.status}} — estimated delivery {{get-tracking.eta}}."
consumes:
- type: http
baseUri: https://api.optum.com/rx/v1
authentication:
type: bearer
token: $secrets.optum_rx_token
resources:
- path: /orders/{orderId}
operations:
- id: getOrderStatus
method: GET
- type: http
baseUri: https://api.optum.com/logistics/v1
authentication:
type: bearer
token: $secrets.optum_logistics_token
resources:
- path: /shipments/{trackingNumber}
operations:
- id: getShipmentTracking
method: GET
- type: http
baseUri: https://graph.microsoft.com/v1.0
authentication:
type: bearer
token: $secrets.ms_graph_token
resources:
- path: /teams/messages
operations:
- id: sendTeamsMessage
method: POST
Pharmacy Prior Auth To Claims Bridge
▼
pharmacy claims healthcare
Bridges pharmacy prior authorization approvals to the claims adjudication system for real-time coverage validation.
naftiko: "0.5"
info:
title: Pharmacy Prior Auth to Claims Bridge
version: "1.0"
description: Bridges pharmacy prior authorization approvals to the claims adjudication system for real-time coverage validation.
tags: [pharmacy, claims, healthcare]
capability:
exposes:
type: mcp
port: 8080
tools:
- name: bridge_pa_to_claims
description: Retrieves approved prior auth, pushes authorization to claims system, and confirms activation.
inputParameters:
- name: auth_id
in: body
required: true
type: string
- name: claim_id
in: body
required: true
type: string
steps:
- name: get-auth
call:
operationId: getPriorAuth
input:
authId: "{{auth_id}}"
- name: update-claims
call:
operationId: updateClaimAuth
input:
claimId: "{{claim_id}}"
authId: "{{auth_id}}"
approvedDrug: "{{get-auth.drug_code}}"
approvedQuantity: "{{get-auth.approved_quantity}}"
- name: confirm-activation
call:
operationId: sendTeamsMessage
input:
channelId: "pharmacy-operations"
message: "Prior auth {{auth_id}} activated for claim {{claim_id}} — drug {{get-auth.drug_code}}."
consumes:
- type: http
baseUri: https://api.optum.com/rx/v1
authentication:
type: bearer
token: $secrets.optum_rx_token
resources:
- path: /prior-authorizations/{authId}
operations:
- id: getPriorAuth
method: GET
- type: http
baseUri: https://api.uhc.com/claims/v2
authentication:
type: bearer
token: $secrets.uhc_claims_token
resources:
- path: /claims/{claimId}/authorization
operations:
- id: updateClaimAuth
method: PUT
- type: http
baseUri: https://graph.microsoft.com/v1.0
authentication:
type: bearer
token: $secrets.ms_graph_token
resources:
- path: /teams/messages
operations:
- id: sendTeamsMessage
method: POST
Population Health Risk Stratification Pipeline
▼
population-health analytics healthcare
Executes risk stratification by querying claims data from Snowflake, scoring members, and pushing results to the care management platform.
naftiko: "0.5"
info:
title: Population Health Risk Stratification Pipeline
version: "1.0"
description: Executes risk stratification by querying claims data from Snowflake, scoring members, and pushing results to the care management platform.
tags: [population-health, analytics, healthcare]
capability:
exposes:
type: mcp
port: 8080
tools:
- name: run_risk_stratification
description: Queries member data, applies risk scoring, and updates the care management system with stratified cohorts.
inputParameters:
- name: population_segment
in: body
required: true
type: string
- name: scoring_model
in: body
required: true
type: string
steps:
- name: query-claims-data
call:
operationId: executeQuery
input:
statement: "SELECT member_id, total_cost, chronic_conditions FROM claims_summary WHERE segment='{{population_segment}}'"
- name: score-members
call:
operationId: runRiskScore
input:
model: "{{scoring_model}}"
data: "{{query-claims-data.results}}"
- name: update-care-mgmt
call:
operationId: updateCohort
input:
segment: "{{population_segment}}"
scores: "{{score-members.results}}"
consumes:
- type: http
baseUri: https://uhc-analytics.snowflakecomputing.com/api/v2
authentication:
type: bearer
token: $secrets.snowflake_token
resources:
- path: /statements
operations:
- id: executeQuery
method: POST
- type: http
baseUri: https://api.optum.com/population-health/v1
authentication:
type: bearer
token: $secrets.optum_ph_token
resources:
- path: /risk-scoring
operations:
- id: runRiskScore
method: POST
- type: http
baseUri: https://api.optum.com/care-management/v1
authentication:
type: bearer
token: $secrets.optum_cm_token
resources:
- path: /cohorts
operations:
- id: updateCohort
method: PUT
Power Bi Claims Analytics Refresh
▼
analytics claims healthcare power-bi
Triggers a Power BI dataset refresh for the claims analytics dashboard and notifies analysts when complete.
naftiko: "0.5"
info:
title: Power BI Claims Analytics Refresh
version: "1.0"
description: Triggers a Power BI dataset refresh for the claims analytics dashboard and notifies analysts when complete.
tags: [analytics, claims, healthcare, power-bi]
capability:
exposes:
type: mcp
port: 8080
tools:
- name: refresh_claims_dashboard
description: Triggers dataset refresh and sends a Teams notification on completion.
inputParameters:
- name: dataset_id
in: body
required: true
type: string
- name: workspace_id
in: body
required: true
type: string
steps:
- name: trigger-refresh
call:
operationId: refreshDataset
input:
datasetId: "{{dataset_id}}"
workspaceId: "{{workspace_id}}"
- name: notify-analysts
call:
operationId: sendTeamsMessage
input:
channelId: "claims-analytics"
message: "Power BI claims dashboard refreshed. Dataset: {{dataset_id}}."
consumes:
- type: http
baseUri: https://api.powerbi.com/v1.0/myorg
authentication:
type: bearer
token: $secrets.powerbi_token
resources:
- path: /groups/{workspaceId}/datasets/{datasetId}/refreshes
operations:
- id: refreshDataset
method: POST
- type: http
baseUri: https://graph.microsoft.com/v1.0
authentication:
type: bearer
token: $secrets.ms_graph_token
resources:
- path: /teams/messages
operations:
- id: sendTeamsMessage
method: POST
Prior Auth Determination And Notification
▼
clinical utilization-management healthcare communication
Submits a prior authorization request, receives determination, and notifies the provider and member.
naftiko: "0.5"
info:
title: Prior Authorization Determination and Notification
version: "1.0"
description: Submits a prior authorization request, receives determination, and notifies the provider and member.
tags: [clinical, utilization-management, healthcare, communication]
capability:
exposes:
type: mcp
port: 8080
tools:
- name: process_prior_auth
description: Submits prior auth, polls for determination, and sends notifications to provider and member channels.
inputParameters:
- name: member_id
in: body
required: true
type: string
- name: service_code
in: body
required: true
type: string
- name: provider_npi
in: body
required: true
type: string
- name: clinical_notes
in: body
required: true
type: string
steps:
- name: submit-auth
call:
operationId: createAuth
input:
memberId: "{{member_id}}"
serviceCode: "{{service_code}}"
providerNpi: "{{provider_npi}}"
clinicalNotes: "{{clinical_notes}}"
- name: notify-provider
call:
operationId: sendTeamsMessage
input:
channelId: "provider-notifications"
message: "Prior auth {{submit-auth.auth_number}} submitted for member {{member_id}} — service {{service_code}}. Status: {{submit-auth.status}}."
- name: notify-member
call:
operationId: sendEmail
input:
to: "{{member_id}}@uhc-member-portal.com"
subject: "Prior Authorization Update"
body: "Your prior authorization request {{submit-auth.auth_number}} has been submitted for review."
consumes:
- type: http
baseUri: https://api.uhc.com/utilization-mgmt/v1
authentication:
type: bearer
token: $secrets.uhc_um_token
resources:
- path: /authorizations
operations:
- id: createAuth
method: POST
- type: http
baseUri: https://graph.microsoft.com/v1.0
authentication:
type: bearer
token: $secrets.ms_graph_token
resources:
- path: /teams/messages
operations:
- id: sendTeamsMessage
method: POST
- type: http
baseUri: https://graph.microsoft.com/v1.0
authentication:
type: bearer
token: $secrets.ms_graph_token
resources:
- path: /me/sendMail
operations:
- id: sendEmail
method: POST
Provider Credentialing Status Sync
▼
provider-network compliance healthcare
Syncs provider credentialing status between the credentialing system and the provider directory, alerting on expirations.
naftiko: "0.5"
info:
title: Provider Credentialing Status Sync
version: "1.0"
description: Syncs provider credentialing status between the credentialing system and the provider directory, alerting on expirations.
tags: [provider-network, compliance, healthcare]
capability:
exposes:
type: mcp
port: 8080
tools:
- name: sync_credentialing
description: Checks credentialing status, updates the directory, and creates alerts for expiring credentials.
inputParameters:
- name: provider_npi
in: body
required: true
type: string
steps:
- name: get-cred-status
call:
operationId: getCredentialingStatus
input:
providerNpi: "{{provider_npi}}"
- name: update-directory
call:
operationId: updateProvider
input:
providerNpi: "{{provider_npi}}"
credentialingStatus: "{{get-cred-status.status}}"
expirationDate: "{{get-cred-status.expiration_date}}"
- name: alert-if-expiring
call:
operationId: createIncident
input:
short_description: "Provider {{provider_npi}} credential expiring {{get-cred-status.expiration_date}}"
urgency: "3"
category: "credentialing"
consumes:
- type: http
baseUri: https://api.uhc.com/credentialing/v1
authentication:
type: bearer
token: $secrets.uhc_cred_token
resources:
- path: /providers/{providerNpi}/status
operations:
- id: getCredentialingStatus
method: GET
- type: http
baseUri: https://api.uhc.com/provider-directory/v2
authentication:
type: bearer
token: $secrets.uhc_provider_token
resources:
- path: /providers/{providerNpi}
operations:
- id: updateProvider
method: PUT
- type: http
baseUri: https://unitedhealth.service-now.com/api/now/v1
authentication:
type: basic
username: $secrets.snow_user
password: $secrets.snow_password
resources:
- path: /table/incident
operations:
- id: createIncident
method: POST
Provider Directory Search
▼
provider-network member-services healthcare
Searches the UnitedHealthcare provider directory by specialty and location to find in-network providers.
naftiko: "0.5"
info:
title: Provider Directory Search
version: "1.0"
description: Searches the UnitedHealthcare provider directory by specialty and location to find in-network providers.
tags: [provider-network, member-services, healthcare]
capability:
exposes:
type: mcp
port: 8080
tools:
- name: search_providers
description: Returns a list of in-network providers matching the given specialty and location criteria.
inputParameters:
- name: specialty
in: query
required: true
type: string
- name: zip_code
in: query
required: true
type: string
- name: radius_miles
in: query
required: true
type: integer
call:
operationId: searchProviders
input:
specialty: "{{specialty}}"
zipCode: "{{zip_code}}"
radiusMiles: "{{radius_miles}}"
outputParameters:
- name: providers
type: array
- name: total_count
type: integer
consumes:
- type: http
baseUri: https://api.uhc.com/provider-directory/v2
authentication:
type: bearer
token: $secrets.uhc_provider_token
resources:
- path: /providers/search
operations:
- id: searchProviders
method: GET
Provider Network Enrollment Lookup
▼
provider-management healthcare member-services
Queries the provider directory to verify a physician's network participation status.
naftiko: "0.5"
info:
title: Provider Network Enrollment Lookup
version: "1.0"
description: Queries the provider directory to verify a physician's network participation status.
tags: [provider-management, healthcare, member-services]
capability:
exposes:
type: mcp
port: 8080
tools:
- name: lookup_provider_enrollment
description: Returns a provider's network participation status and contract tier.
inputParameters:
- name: npi
in: query
required: true
type: string
- name: plan_id
in: query
required: true
type: string
call:
operationId: getProviderStatus
input:
npi: "{{npi}}"
planId: "{{plan_id}}"
outputParameters:
- name: network_status
type: string
- name: contract_tier
type: string
- name: effective_date
type: string
consumes:
- type: http
baseUri: https://api.uhc.com/providers/v1
authentication:
type: bearer
token: $secrets.uhc_provider_token
resources:
- path: /providers/{npi}/enrollment
operations:
- id: getProviderStatus
method: GET
Provider Payment Reconciliation
▼
claims provider-network healthcare
Reconciles provider payment amounts against contracted rates and flags discrepancies for review in ServiceNow.
naftiko: "0.5"
info:
title: Provider Payment Reconciliation
version: "1.0"
description: Reconciles provider payment amounts against contracted rates and flags discrepancies for review in ServiceNow.
tags: [claims, provider-network, healthcare]
capability:
exposes:
type: mcp
port: 8080
tools:
- name: reconcile_provider_payments
description: Queries payments, compares against contracted rates, and creates discrepancy tickets.
inputParameters:
- name: provider_npi
in: body
required: true
type: string
- name: payment_period
in: body
required: true
type: string
steps:
- name: query-payments
call:
operationId: executeQuery
input:
statement: "SELECT claim_id, paid_amount, contracted_rate FROM provider_payments WHERE npi='{{provider_npi}}' AND period='{{payment_period}}'"
- name: flag-discrepancies
call:
operationId: createIncident
input:
short_description: "Payment discrepancy for provider {{provider_npi}} in {{payment_period}}"
category: "payment_reconciliation"
consumes:
- type: http
baseUri: https://uhc-analytics.snowflakecomputing.com/api/v2
authentication:
type: bearer
token: $secrets.snowflake_token
resources:
- path: /statements
operations:
- id: executeQuery
method: POST
- type: http
baseUri: https://unitedhealth.service-now.com/api/now/v1
authentication:
type: basic
username: $secrets.snow_user
password: $secrets.snow_password
resources:
- path: /table/incident
operations:
- id: createIncident
method: POST
Rally Health Wellness Score
▼
population-health wellness healthcare
Retrieves the wellness engagement score for a member from the Rally Health platform.
naftiko: "0.5"
info:
title: Rally Health Wellness Score Lookup
version: "1.0"
description: Retrieves the wellness engagement score for a member from the Rally Health platform.
tags: [population-health, wellness, healthcare]
capability:
exposes:
type: mcp
port: 8080
tools:
- name: get_wellness_score
description: Returns the member's current wellness score, activity streaks, and reward points balance.
inputParameters:
- name: member_id
in: query
required: true
type: string
call:
operationId: getWellnessScore
input:
memberId: "{{member_id}}"
outputParameters:
- name: wellness_score
type: integer
- name: activity_streak_days
type: integer
- name: reward_points
type: integer
consumes:
- type: http
baseUri: https://api.rallyhealth.com/v1
authentication:
type: bearer
token: $secrets.rally_health_token
resources:
- path: /members/{memberId}/wellness-score
operations:
- id: getWellnessScore
method: GET
Recruiting Pipeline Digest
▼
hr recruiting communication
Pulls open requisition and candidate pipeline data from Workday Recruiting and posts a weekly digest to the Talent Acquisition Teams channel.
naftiko: "0.5"
info:
title: Recruiting Pipeline Digest
version: "1.0"
description: Pulls open requisition and candidate pipeline data from Workday Recruiting and posts a weekly digest to the Talent Acquisition Teams channel.
tags: [hr, recruiting, communication]
capability:
exposes:
type: mcp
port: 8080
tools:
- name: post_recruiting_digest
description: Summarizes open reqs and pipeline stage counts and posts to Talent Acquisition channel.
inputParameters:
- name: department
in: query
required: true
type: string
steps:
- name: get-open-reqs
call:
operationId: getOpenRequisitions
input:
department: "{{department}}"
- name: post-digest
call:
operationId: sendTeamsMessage
input:
channelId: talent-acquisition
message: "Recruiting digest for {{department}}: {{get-open-reqs.total_reqs}} open reqs, {{get-open-reqs.candidates_in_pipeline}} candidates in pipeline."
consumes:
- type: http
baseUri: https://wd3-impl-services1.workday.com/ccx/service/unitedhealth
authentication:
type: bearer
token: $secrets.workday_token
resources:
- path: /recruiting/requisitions
operations:
- id: getOpenRequisitions
method: GET
- type: http
baseUri: https://graph.microsoft.com/v1.0
authentication:
type: bearer
token: $secrets.ms_graph_token
resources:
- path: /teams/messages
operations:
- id: sendTeamsMessage
method: POST
Regulatory Compliance Audit Report
▼
compliance security communication
Pulls compliance control status from ServiceNow GRC and assembles a regulatory audit report posted to the Compliance Teams channel.
naftiko: "0.5"
info:
title: Regulatory Compliance Audit Report
version: "1.0"
description: Pulls compliance control status from ServiceNow GRC and assembles a regulatory audit report posted to the Compliance Teams channel.
tags: [compliance, security, communication]
capability:
exposes:
type: mcp
port: 8080
tools:
- name: run_compliance_audit
description: Retrieves GRC control statuses and posts a summary to the Compliance channel.
inputParameters:
- name: regulation
in: query
required: true
type: string
- name: reporting_period
in: query
required: true
type: string
steps:
- name: get-controls
call:
operationId: getComplianceControls
input:
regulation: "{{regulation}}"
period: "{{reporting_period}}"
- name: post-summary
call:
operationId: sendTeamsMessage
input:
channelId: compliance-reports
message: "Compliance audit for {{regulation}} ({{reporting_period}}): {{get-controls.passing}} passing, {{get-controls.failing}} failing controls."
consumes:
- type: http
baseUri: https://unitedhealth.service-now.com/api/now/v1
authentication:
type: basic
username: $secrets.snow_user
password: $secrets.snow_password
resources:
- path: /table/sn_compliance_policy_statement
operations:
- id: getComplianceControls
method: GET
- type: http
baseUri: https://graph.microsoft.com/v1.0
authentication:
type: bearer
token: $secrets.ms_graph_token
resources:
- path: /teams/messages
operations:
- id: sendTeamsMessage
method: POST
Regulatory Filing Submission Tracker
▼
compliance healthcare regulatory
Tracks regulatory filing deadlines, submits filings, and creates audit trail entries in ServiceNow.
naftiko: "0.5"
info:
title: Regulatory Filing Submission Tracker
version: "1.0"
description: Tracks regulatory filing deadlines, submits filings, and creates audit trail entries in ServiceNow.
tags: [compliance, healthcare, regulatory]
capability:
exposes:
type: mcp
port: 8080
tools:
- name: submit_regulatory_filing
description: Retrieves filing requirements, submits the filing, and logs the submission for audit purposes.
inputParameters:
- name: filing_type
in: body
required: true
type: string
- name: state
in: body
required: true
type: string
- name: reporting_period
in: body
required: true
type: string
steps:
- name: get-filing-requirements
call:
operationId: getFilingRequirements
input:
filingType: "{{filing_type}}"
state: "{{state}}"
period: "{{reporting_period}}"
- name: submit-filing
call:
operationId: submitFiling
input:
filingType: "{{filing_type}}"
state: "{{state}}"
data: "{{get-filing-requirements.data_package}}"
- name: log-submission
call:
operationId: createIncident
input:
short_description: "Regulatory filing submitted: {{filing_type}} — {{state}} — {{reporting_period}}"
category: "regulatory_compliance"
urgency: "3"
consumes:
- type: http
baseUri: https://api.uhc.com/regulatory/v1
authentication:
type: bearer
token: $secrets.uhc_regulatory_token
resources:
- path: /filings/requirements
operations:
- id: getFilingRequirements
method: GET
- type: http
baseUri: https://api.uhc.com/regulatory/v1
authentication:
type: bearer
token: $secrets.uhc_regulatory_token
resources:
- path: /filings/submit
operations:
- id: submitFiling
method: POST
- type: http
baseUri: https://unitedhealth.service-now.com/api/now/v1
authentication:
type: basic
username: $secrets.snow_user
password: $secrets.snow_password
resources:
- path: /table/incident
operations:
- id: createIncident
method: POST
Salesforce Member Account Enrichment
▼
crm member-services healthcare
Looks up a health plan member in Salesforce Health Cloud and enriches the record with claims and plan data.
naftiko: "0.5"
info:
title: Salesforce Member Account Enrichment
version: "1.0"
description: Looks up a health plan member in Salesforce Health Cloud and enriches the record with claims and plan data.
tags: [crm, member-services, healthcare]
capability:
exposes:
type: mcp
port: 8080
tools:
- name: enrich_member_account
description: Retrieves and enriches a member account in Salesforce Health Cloud with latest claims data.
inputParameters:
- name: member_id
in: query
required: true
type: string
steps:
- name: lookup-member
call:
operationId: queryMemberAccount
input:
memberId: "{{member_id}}"
- name: get-claims-summary
call:
operationId: getClaimSummary
input:
memberId: "{{member_id}}"
- name: update-sf-record
call:
operationId: updateMemberAccount
input:
accountId: "{{lookup-member.id}}"
claimCount: "{{get-claims-summary.total_claims}}"
lastClaimDate: "{{get-claims-summary.last_claim_date}}"
consumes:
- type: http
baseUri: https://unitedhealth.my.salesforce.com/services/data/v58.0
authentication:
type: bearer
token: $secrets.salesforce_token
resources:
- path: /query
operations:
- id: queryMemberAccount
method: GET
- path: /sobjects/Account/{accountId}
operations:
- id: updateMemberAccount
method: PATCH
- type: http
baseUri: https://api.uhc.com/claims/v2
authentication:
type: bearer
token: $secrets.uhc_claims_token
resources:
- path: /claims/summary
operations:
- id: getClaimSummary
method: GET
Salesforce Provider Contract Renewal
▼
provider-network salesforce healthcare
Manages provider contract renewal workflow by pulling contract terms, generating renewal proposal, and creating Salesforce opportunity.
naftiko: "0.5"
info:
title: Salesforce Provider Contract Renewal
version: "1.0"
description: Manages provider contract renewal workflow by pulling contract terms, generating renewal proposal, and creating Salesforce opportunity.
tags: [provider-network, salesforce, healthcare]
capability:
exposes:
type: mcp
port: 8080
tools:
- name: renew_provider_contract
description: Retrieves contract details, generates renewal terms, and creates a Salesforce opportunity.
inputParameters:
- name: contract_id
in: body
required: true
type: string
- name: provider_npi
in: body
required: true
type: string
steps:
- name: get-contract
call:
operationId: getContract
input:
contractId: "{{contract_id}}"
- name: generate-renewal
call:
operationId: generateRenewalTerms
input:
contractId: "{{contract_id}}"
currentTerms: "{{get-contract.terms}}"
providerNpi: "{{provider_npi}}"
- name: create-opportunity
call:
operationId: createOpportunity
input:
name: "Contract Renewal — {{provider_npi}} — {{contract_id}}"
contractId: "{{contract_id}}"
proposedTerms: "{{generate-renewal.proposed_terms}}"
consumes:
- type: http
baseUri: https://api.uhc.com/contracts/v1
authentication:
type: bearer
token: $secrets.uhc_contracts_token
resources:
- path: /contracts/{contractId}
operations:
- id: getContract
method: GET
- type: http
baseUri: https://api.uhc.com/contracts/v1
authentication:
type: bearer
token: $secrets.uhc_contracts_token
resources:
- path: /renewals
operations:
- id: generateRenewalTerms
method: POST
- type: http
baseUri: https://unitedhealth.my.salesforce.com/services/data/v58.0
authentication:
type: bearer
token: $secrets.salesforce_token
resources:
- path: /sobjects/Opportunity
operations:
- id: createOpportunity
method: POST
Sap Healthcare Procurement Approval
▼
procurement sap healthcare
Routes healthcare equipment procurement requests through SAP approval workflow and notifies finance via Teams.
naftiko: "0.5"
info:
title: SAP Healthcare Procurement Approval
version: "1.0"
description: Routes healthcare equipment procurement requests through SAP approval workflow and notifies finance via Teams.
tags: [procurement, sap, healthcare]
capability:
exposes:
type: mcp
port: 8080
tools:
- name: process_procurement_approval
description: Submits purchase requisition, routes for approval, and notifies the finance team.
inputParameters:
- name: requisition_id
in: body
required: true
type: string
- name: department
in: body
required: true
type: string
steps:
- name: get-requisition
call:
operationId: getRequisition
input:
requisitionId: "{{requisition_id}}"
- name: submit-approval
call:
operationId: submitApproval
input:
requisitionId: "{{requisition_id}}"
department: "{{department}}"
amount: "{{get-requisition.total_amount}}"
- name: notify-finance
call:
operationId: sendTeamsMessage
input:
channelId: "finance-approvals"
message: "Procurement requisition {{requisition_id}} for {{department}} — ${{get-requisition.total_amount}} submitted for approval."
consumes:
- type: http
baseUri: https://unitedhealth-sap.com/api/v1
authentication:
type: bearer
token: $secrets.sap_token
resources:
- path: /requisitions/{requisitionId}
operations:
- id: getRequisition
method: GET
- type: http
baseUri: https://unitedhealth-sap.com/api/v1
authentication:
type: bearer
token: $secrets.sap_token
resources:
- path: /approvals
operations:
- id: submitApproval
method: POST
- type: http
baseUri: https://graph.microsoft.com/v1.0
authentication:
type: bearer
token: $secrets.ms_graph_token
resources:
- path: /teams/messages
operations:
- id: sendTeamsMessage
method: POST
Sap Medical Supply Chain Order
▼
procurement sap healthcare
Creates a medical supply order in SAP, validates inventory availability, and schedules delivery with notification.
naftiko: "0.5"
info:
title: SAP Medical Supply Chain Order
version: "1.0"
description: Creates a medical supply order in SAP, validates inventory availability, and schedules delivery with notification.
tags: [procurement, sap, healthcare]
capability:
exposes:
type: mcp
port: 8080
tools:
- name: create_supply_order
description: Checks inventory, creates a purchase order, and schedules delivery.
inputParameters:
- name: material_id
in: body
required: true
type: string
- name: quantity
in: body
required: true
type: integer
- name: facility_code
in: body
required: true
type: string
steps:
- name: check-inventory
call:
operationId: checkInventory
input:
materialId: "{{material_id}}"
facilityCode: "{{facility_code}}"
- name: create-po
call:
operationId: createPurchaseOrder
input:
materialId: "{{material_id}}"
quantity: "{{quantity}}"
facilityCode: "{{facility_code}}"
- name: notify-logistics
call:
operationId: sendTeamsMessage
input:
channelId: "supply-chain"
message: "PO {{create-po.po_number}} created for {{quantity}} units of {{material_id}} to facility {{facility_code}}."
consumes:
- type: http
baseUri: https://unitedhealth-sap.com/api/v1
authentication:
type: bearer
token: $secrets.sap_token
resources:
- path: /inventory/{materialId}
operations:
- id: checkInventory
method: GET
- type: http
baseUri: https://unitedhealth-sap.com/api/v1
authentication:
type: bearer
token: $secrets.sap_token
resources:
- path: /purchase-orders
operations:
- id: createPurchaseOrder
method: POST
- type: http
baseUri: https://graph.microsoft.com/v1.0
authentication:
type: bearer
token: $secrets.ms_graph_token
resources:
- path: /teams/messages
operations:
- id: sendTeamsMessage
method: POST
Sap Purchase Order Lookup
▼
procurement erp finance
Retrieves purchase order details from SAP S/4HANA for procurement review.
naftiko: "0.5"
info:
title: SAP Purchase Order Lookup
version: "1.0"
description: Retrieves purchase order details from SAP S/4HANA for procurement review.
tags: [procurement, erp, finance]
capability:
exposes:
type: mcp
port: 8080
tools:
- name: lookup_purchase_order
description: Returns purchase order header and line item details from SAP.
inputParameters:
- name: po_number
in: path
required: true
type: string
call:
operationId: getPurchaseOrder
input:
poNumber: "{{po_number}}"
outputParameters:
- name: vendor
type: string
- name: total_amount
type: number
- name: status
type: string
- name: line_items
type: array
consumes:
- type: http
baseUri: https://unitedhealth-sap.example.com/sap/opu/odata/sap
authentication:
type: basic
username: $secrets.sap_user
password: $secrets.sap_password
resources:
- path: /API_PURCHASEORDER_PROCESS_SRV/A_PurchaseOrder('{poNumber}')
operations:
- id: getPurchaseOrder
method: GET
Servicenow Clinical Change Request Lookup
▼
itsm clinical servicenow
Retrieves the status and details of a clinical system change request from ServiceNow.
naftiko: "0.5"
info:
title: ServiceNow Clinical Change Request Lookup
version: "1.0"
description: Retrieves the status and details of a clinical system change request from ServiceNow.
tags: [itsm, clinical, servicenow]
capability:
exposes:
type: mcp
port: 8080
tools:
- name: get_clinical_change
description: Returns change request state, risk assessment, and implementation schedule.
inputParameters:
- name: change_number
in: query
required: true
type: string
call:
operationId: getChangeRequest
input:
number: "{{change_number}}"
outputParameters:
- name: state
type: string
- name: risk
type: string
- name: scheduled_start
type: string
consumes:
- type: http
baseUri: https://unitedhealth.service-now.com/api/now/v1
authentication:
type: basic
username: $secrets.snow_user
password: $secrets.snow_password
resources:
- path: /table/change_request
operations:
- id: getChangeRequest
method: GET
Snowflake Hedis Measure Query
▼
population-health analytics snowflake
Queries the Snowflake analytics warehouse for HEDIS quality measure compliance rates.
naftiko: "0.5"
info:
title: Snowflake HEDIS Measure Query
version: "1.0"
description: Queries the Snowflake analytics warehouse for HEDIS quality measure compliance rates.
tags: [population-health, analytics, snowflake]
capability:
exposes:
type: mcp
port: 8080
tools:
- name: query_hedis_measures
description: Returns compliance rates for specified HEDIS measures by population segment.
inputParameters:
- name: measure_code
in: query
required: true
type: string
- name: reporting_year
in: query
required: true
type: string
call:
operationId: executeQuery
input:
statement: "SELECT measure_code, compliance_rate, denominator, numerator FROM hedis_measures WHERE measure_code='{{measure_code}}' AND year='{{reporting_year}}'"
outputParameters:
- name: results
type: array
consumes:
- type: http
baseUri: https://uhc-analytics.snowflakecomputing.com/api/v2
authentication:
type: bearer
token: $secrets.snowflake_token
resources:
- path: /statements
operations:
- id: executeQuery
method: POST
Splunk Security Event Correlation
▼
security compliance healthcare splunk
Correlates security events from Splunk with PHI access patterns and escalates suspicious activity to the SOC.
naftiko: "0.5"
info:
title: Splunk Security Event Correlation
version: "1.0"
description: Correlates security events from Splunk with PHI access patterns and escalates suspicious activity to the SOC.
tags: [security, compliance, healthcare, splunk]
capability:
exposes:
type: mcp
port: 8080
tools:
- name: correlate_security_events
description: Queries Splunk security events, correlates with PHI access, and creates SOC escalation tickets.
inputParameters:
- name: time_window
in: body
required: true
type: string
- name: event_type
in: body
required: true
type: string
steps:
- name: query-events
call:
operationId: searchEvents
input:
query: "index=security event_type={{event_type}} earliest={{time_window}}"
output_mode: "json"
- name: create-escalation
call:
operationId: createIncident
input:
short_description: "Security event correlation: {{event_type}}"
urgency: "1"
category: "security_operations"
- name: notify-soc
call:
operationId: sendTeamsMessage
input:
channelId: "soc-alerts"
message: "Security escalation: {{event_type}} events correlated. Incident: {{create-escalation.number}}."
consumes:
- type: http
baseUri: https://unitedhealth-splunk.com:8089/services
authentication:
type: bearer
token: $secrets.splunk_token
resources:
- path: /search/jobs
operations:
- id: searchEvents
method: POST
- type: http
baseUri: https://unitedhealth.service-now.com/api/now/v1
authentication:
type: basic
username: $secrets.snow_user
password: $secrets.snow_password
resources:
- path: /table/incident
operations:
- id: createIncident
method: POST
- type: http
baseUri: https://graph.microsoft.com/v1.0
authentication:
type: bearer
token: $secrets.ms_graph_token
resources:
- path: /teams/messages
operations:
- id: sendTeamsMessage
method: POST
Telehealth Visit Summary Distribution
▼
clinical telehealth healthcare communication
Retrieves a completed telehealth visit summary and distributes it to the member's PCP and care coordinator via email.
naftiko: "0.5"
info:
title: Telehealth Visit Summary Distribution
version: "1.0"
description: Retrieves a completed telehealth visit summary and distributes it to the member's PCP and care coordinator via email.
tags: [clinical, telehealth, healthcare, communication]
capability:
exposes:
type: mcp
port: 8080
tools:
- name: distribute_visit_summary
description: Fetches visit notes, identifies the PCP, and sends the summary to relevant care team members.
inputParameters:
- name: visit_id
in: body
required: true
type: string
- name: member_id
in: body
required: true
type: string
steps:
- name: get-visit-summary
call:
operationId: getVisitSummary
input:
visitId: "{{visit_id}}"
- name: get-pcp
call:
operationId: getMemberPCP
input:
memberId: "{{member_id}}"
- name: send-summary
call:
operationId: sendEmail
input:
to: "{{get-pcp.email}}"
subject: "Telehealth Visit Summary — {{member_id}}"
body: "Visit {{visit_id}} notes: {{get-visit-summary.notes}}"
consumes:
- type: http
baseUri: https://api.uhc.com/telehealth/v1
authentication:
type: bearer
token: $secrets.uhc_telehealth_token
resources:
- path: /visits/{visitId}/summary
operations:
- id: getVisitSummary
method: GET
- type: http
baseUri: https://api.uhc.com/enrollment/v1
authentication:
type: bearer
token: $secrets.uhc_enrollment_token
resources:
- path: /members/{memberId}/pcp
operations:
- id: getMemberPCP
method: GET
- type: http
baseUri: https://graph.microsoft.com/v1.0
authentication:
type: bearer
token: $secrets.ms_graph_token
resources:
- path: /me/sendMail
operations:
- id: sendEmail
method: POST
Terraform Healthcare Env Provisioner
▼
infrastructure devops healthcare terraform
Provisions HIPAA-compliant cloud environments using Terraform and registers infrastructure in the CMDB.
naftiko: "0.5"
info:
title: Terraform Healthcare Environment Provisioner
version: "1.0"
description: Provisions HIPAA-compliant cloud environments using Terraform and registers infrastructure in the CMDB.
tags: [infrastructure, devops, healthcare, terraform]
capability:
exposes:
type: mcp
port: 8080
tools:
- name: provision_healthcare_env
description: Triggers Terraform plan execution and registers provisioned resources in ServiceNow CMDB.
inputParameters:
- name: environment_name
in: body
required: true
type: string
- name: workspace_id
in: body
required: true
type: string
steps:
- name: trigger-apply
call:
operationId: triggerRun
input:
workspaceId: "{{workspace_id}}"
message: "Provisioning {{environment_name}}"
- name: register-cmdb
call:
operationId: createCI
input:
name: "{{environment_name}}"
category: "cloud_infrastructure"
environment: "{{environment_name}}"
- name: notify-team
call:
operationId: sendTeamsMessage
input:
channelId: "platform-engineering"
message: "Healthcare environment {{environment_name}} provisioned. Terraform run: {{trigger-apply.run_id}}."
consumes:
- type: http
baseUri: https://app.terraform.io/api/v2
authentication:
type: bearer
token: $secrets.terraform_token
resources:
- path: /runs
operations:
- id: triggerRun
method: POST
- type: http
baseUri: https://unitedhealth.service-now.com/api/now/v1
authentication:
type: basic
username: $secrets.snow_user
password: $secrets.snow_password
resources:
- path: /table/cmdb_ci
operations:
- id: createCI
method: POST
- type: http
baseUri: https://graph.microsoft.com/v1.0
authentication:
type: bearer
token: $secrets.ms_graph_token
resources:
- path: /teams/messages
operations:
- id: sendTeamsMessage
method: POST
Uhc Authorization Status Check
▼
clinical utilization-management healthcare
Checks the current status of a medical service authorization request in the UHC utilization management system.
naftiko: "0.5"
info:
title: UHC Authorization Status Check
version: "1.0"
description: Checks the current status of a medical service authorization request in the UHC utilization management system.
tags: [clinical, utilization-management, healthcare]
capability:
exposes:
type: mcp
port: 8080
tools:
- name: check_auth_status
description: Returns authorization status, determination date, and approved service details.
inputParameters:
- name: auth_number
in: query
required: true
type: string
call:
operationId: getAuthStatus
input:
authNumber: "{{auth_number}}"
outputParameters:
- name: status
type: string
- name: determination_date
type: string
- name: approved_units
type: integer
consumes:
- type: http
baseUri: https://api.uhc.com/utilization-mgmt/v1
authentication:
type: bearer
token: $secrets.uhc_um_token
resources:
- path: /authorizations/{authNumber}
operations:
- id: getAuthStatus
method: GET
Uhc Cobra Enrollment Processor
▼
enrollment employer-group healthcare
Processes COBRA continuation coverage enrollment by validating qualifying event, calculating premiums, and activating coverage.
naftiko: "0.5"
info:
title: UHC COBRA Enrollment Processor
version: "1.0"
description: Processes COBRA continuation coverage enrollment by validating qualifying event, calculating premiums, and activating coverage.
tags: [enrollment, employer-group, healthcare]
capability:
exposes:
type: mcp
port: 8080
tools:
- name: process_cobra_enrollment
description: Validates COBRA eligibility, calculates premiums, and activates continuation coverage.
inputParameters:
- name: member_id
in: body
required: true
type: string
- name: qualifying_event
in: body
required: true
type: string
- name: event_date
in: body
required: true
type: string
steps:
- name: validate-event
call:
operationId: validateQualifyingEvent
input:
memberId: "{{member_id}}"
event: "{{qualifying_event}}"
eventDate: "{{event_date}}"
- name: calculate-premium
call:
operationId: calculateCOBRAPremium
input:
memberId: "{{member_id}}"
eventType: "{{qualifying_event}}"
previousPlan: "{{validate-event.previous_plan}}"
- name: activate-coverage
call:
operationId: activateCOBRA
input:
memberId: "{{member_id}}"
premium: "{{calculate-premium.monthly_premium}}"
effectiveDate: "{{validate-event.cobra_start_date}}"
consumes:
- type: http
baseUri: https://api.uhc.com/cobra/v1
authentication:
type: bearer
token: $secrets.uhc_cobra_token
resources:
- path: /qualifying-events
operations:
- id: validateQualifyingEvent
method: POST
- type: http
baseUri: https://api.uhc.com/cobra/v1
authentication:
type: bearer
token: $secrets.uhc_cobra_token
resources:
- path: /premiums
operations:
- id: calculateCOBRAPremium
method: POST
- type: http
baseUri: https://api.uhc.com/enrollment/v1
authentication:
type: bearer
token: $secrets.uhc_enrollment_token
resources:
- path: /cobra/activate
operations:
- id: activateCOBRA
method: POST
Uhc Deductible Accumulator Check
▼
claims member-services healthcare
Checks the current deductible and out-of-pocket accumulator balances for a UnitedHealthcare member.
naftiko: "0.5"
info:
title: UHC Deductible Accumulator Check
version: "1.0"
description: Checks the current deductible and out-of-pocket accumulator balances for a UnitedHealthcare member.
tags: [claims, member-services, healthcare]
capability:
exposes:
type: mcp
port: 8080
tools:
- name: check_accumulators
description: Returns deductible met amount, out-of-pocket max, and remaining balances for the plan year.
inputParameters:
- name: member_id
in: query
required: true
type: string
- name: plan_year
in: query
required: true
type: string
call:
operationId: getAccumulators
input:
memberId: "{{member_id}}"
planYear: "{{plan_year}}"
outputParameters:
- name: deductible_met
type: number
- name: deductible_max
type: number
- name: oop_met
type: number
- name: oop_max
type: number
consumes:
- type: http
baseUri: https://api.uhc.com/accumulators/v1
authentication:
type: bearer
token: $secrets.uhc_claims_token
resources:
- path: /members/{memberId}/accumulators
operations:
- id: getAccumulators
method: GET
Uhc Fraud Detection Alert Workflow
▼
claims compliance healthcare
Detects potential claims fraud patterns, creates a special investigation unit case, and notifies compliance.
naftiko: "0.5"
info:
title: UHC Fraud Detection Alert Workflow
version: "1.0"
description: Detects potential claims fraud patterns, creates a special investigation unit case, and notifies compliance.
tags: [claims, compliance, healthcare]
capability:
exposes:
type: mcp
port: 8080
tools:
- name: process_fraud_alert
description: Queries anomalous claim patterns, creates an SIU case, and escalates to compliance team.
inputParameters:
- name: provider_npi
in: body
required: true
type: string
- name: anomaly_type
in: body
required: true
type: string
steps:
- name: query-anomalies
call:
operationId: executeQuery
input:
statement: "SELECT claim_id, amount, service_date FROM claims WHERE provider_npi='{{provider_npi}}' AND anomaly_flag='{{anomaly_type}}'"
- name: create-siu-case
call:
operationId: createIncident
input:
short_description: "Fraud alert — {{anomaly_type}} for provider {{provider_npi}}"
urgency: "1"
category: "fraud_investigation"
- name: notify-compliance
call:
operationId: sendTeamsMessage
input:
channelId: "siu-compliance"
message: "Fraud alert: {{anomaly_type}} detected for provider {{provider_npi}}. SIU case: {{create-siu-case.number}}."
consumes:
- type: http
baseUri: https://uhc-analytics.snowflakecomputing.com/api/v2
authentication:
type: bearer
token: $secrets.snowflake_token
resources:
- path: /statements
operations:
- id: executeQuery
method: POST
- type: http
baseUri: https://unitedhealth.service-now.com/api/now/v1
authentication:
type: basic
username: $secrets.snow_user
password: $secrets.snow_password
resources:
- path: /table/incident
operations:
- id: createIncident
method: POST
- type: http
baseUri: https://graph.microsoft.com/v1.0
authentication:
type: bearer
token: $secrets.ms_graph_token
resources:
- path: /teams/messages
operations:
- id: sendTeamsMessage
method: POST
Uhc Group Enrollment Census Lookup
▼
enrollment employer-group healthcare
Retrieves the current enrollment census for an employer group including active member counts by plan.
naftiko: "0.5"
info:
title: UHC Group Enrollment Census Lookup
version: "1.0"
description: Retrieves the current enrollment census for an employer group including active member counts by plan.
tags: [enrollment, employer-group, healthcare]
capability:
exposes:
type: mcp
port: 8080
tools:
- name: get_group_census
description: Returns plan-level enrollment counts, total members, and dependents for an employer group.
inputParameters:
- name: group_id
in: query
required: true
type: string
call:
operationId: getGroupCensus
input:
groupId: "{{group_id}}"
outputParameters:
- name: total_members
type: integer
- name: plans
type: array
consumes:
- type: http
baseUri: https://api.uhc.com/enrollment/v1
authentication:
type: bearer
token: $secrets.uhc_enrollment_token
resources:
- path: /groups/{groupId}/census
operations:
- id: getGroupCensus
method: GET
Uhc Medicare Advantage Plan Details
▼
enrollment medicare healthcare
Retrieves plan details for a UnitedHealthcare Medicare Advantage plan including benefits and premiums.
naftiko: "0.5"
info:
title: UHC Medicare Advantage Plan Details
version: "1.0"
description: Retrieves plan details for a UnitedHealthcare Medicare Advantage plan including benefits and premiums.
tags: [enrollment, medicare, healthcare]
capability:
exposes:
type: mcp
port: 8080
tools:
- name: get_ma_plan_details
description: Returns plan name, monthly premium, drug coverage tier, and supplemental benefit details.
inputParameters:
- name: plan_id
in: query
required: true
type: string
- name: county_fips
in: query
required: true
type: string
call:
operationId: getMedicarePlan
input:
planId: "{{plan_id}}"
countyFips: "{{county_fips}}"
outputParameters:
- name: plan_name
type: string
- name: monthly_premium
type: number
- name: drug_deductible
type: number
consumes:
- type: http
baseUri: https://api.uhc.com/medicare/v1
authentication:
type: bearer
token: $secrets.uhc_medicare_token
resources:
- path: /plans/{planId}
operations:
- id: getMedicarePlan
method: GET
Uhc Network Tier Check
▼
provider-network claims healthcare
Determines the network tier designation for a specific provider under a member's plan.
naftiko: "0.5"
info:
title: UHC Network Tier Check
version: "1.0"
description: Determines the network tier designation for a specific provider under a member's plan.
tags: [provider-network, claims, healthcare]
capability:
exposes:
type: mcp
port: 8080
tools:
- name: check_network_tier
description: Returns the provider's network tier, cost-sharing level, and effective date range.
inputParameters:
- name: provider_npi
in: query
required: true
type: string
- name: plan_id
in: query
required: true
type: string
call:
operationId: getNetworkTier
input:
providerNpi: "{{provider_npi}}"
planId: "{{plan_id}}"
outputParameters:
- name: tier
type: string
- name: in_network
type: boolean
- name: effective_date
type: string
consumes:
- type: http
baseUri: https://api.uhc.com/provider-directory/v2
authentication:
type: bearer
token: $secrets.uhc_provider_token
resources:
- path: /providers/{providerNpi}/tier
operations:
- id: getNetworkTier
method: GET
Uhc Pharmacy Network Check
▼
pharmacy provider-network healthcare
Verifies whether a pharmacy is in-network for a member's prescription benefit plan.
naftiko: "0.5"
info:
title: UHC Pharmacy Network Check
version: "1.0"
description: Verifies whether a pharmacy is in-network for a member's prescription benefit plan.
tags: [pharmacy, provider-network, healthcare]
capability:
exposes:
type: mcp
port: 8080
tools:
- name: check_pharmacy_network
description: Returns network status, pharmacy details, and cost-sharing tier for the specified pharmacy.
inputParameters:
- name: pharmacy_ncpdp
in: query
required: true
type: string
- name: plan_id
in: query
required: true
type: string
call:
operationId: checkPharmacyNetwork
input:
pharmacyNcpdp: "{{pharmacy_ncpdp}}"
planId: "{{plan_id}}"
outputParameters:
- name: in_network
type: boolean
- name: pharmacy_name
type: string
- name: tier
type: string
consumes:
- type: http
baseUri: https://api.optum.com/rx/v1
authentication:
type: bearer
token: $secrets.optum_rx_token
resources:
- path: /pharmacies/{pharmacyNcpdp}/network-status
operations:
- id: checkPharmacyNetwork
method: GET
Uhc Plan Comparison Tool
▼
enrollment member-services healthcare
Compares two UnitedHealthcare plan options side-by-side for a prospective member during open enrollment.
naftiko: "0.5"
info:
title: UHC Plan Comparison Tool
version: "1.0"
description: Compares two UnitedHealthcare plan options side-by-side for a prospective member during open enrollment.
tags: [enrollment, member-services, healthcare]
capability:
exposes:
type: mcp
port: 8080
tools:
- name: compare_plans
description: Returns a comparison of premiums, deductibles, copays, and covered services for two plans.
inputParameters:
- name: plan_id_a
in: query
required: true
type: string
- name: plan_id_b
in: query
required: true
type: string
- name: zip_code
in: query
required: true
type: string
call:
operationId: comparePlans
input:
planIdA: "{{plan_id_a}}"
planIdB: "{{plan_id_b}}"
zipCode: "{{zip_code}}"
outputParameters:
- name: comparison
type: object
consumes:
- type: http
baseUri: https://api.uhc.com/enrollment/v1
authentication:
type: bearer
token: $secrets.uhc_enrollment_token
resources:
- path: /plans/compare
operations:
- id: comparePlans
method: GET
Uhc Virtual Visit Availability
▼
clinical telehealth healthcare
Checks available virtual visit appointment slots for a member through the UHC telehealth platform.
naftiko: "0.5"
info:
title: UHC Virtual Visit Availability
version: "1.0"
description: Checks available virtual visit appointment slots for a member through the UHC telehealth platform.
tags: [clinical, telehealth, healthcare]
capability:
exposes:
type: mcp
port: 8080
tools:
- name: get_virtual_availability
description: Returns available appointment slots by provider specialty and preferred time window.
inputParameters:
- name: member_id
in: query
required: true
type: string
- name: specialty
in: query
required: true
type: string
- name: date
in: query
required: true
type: string
call:
operationId: getAvailability
input:
memberId: "{{member_id}}"
specialty: "{{specialty}}"
date: "{{date}}"
outputParameters:
- name: slots
type: array
- name: total_available
type: integer
consumes:
- type: http
baseUri: https://api.uhc.com/telehealth/v1
authentication:
type: bearer
token: $secrets.uhc_telehealth_token
resources:
- path: /virtual-visits/availability
operations:
- id: getAvailability
method: GET
Value Based Care Contract Performance
▼
population-health analytics healthcare salesforce
Retrieves value-based care contract metrics from Snowflake and updates the Salesforce account with performance indicators.
naftiko: "0.5"
info:
title: Value-Based Care Contract Performance
version: "1.0"
description: Retrieves value-based care contract metrics from Snowflake and updates the Salesforce account with performance indicators.
tags: [population-health, analytics, healthcare, salesforce]
capability:
exposes:
type: mcp
port: 8080
tools:
- name: update_vbc_performance
description: Queries contract performance metrics and syncs quality and cost indicators to Salesforce.
inputParameters:
- name: contract_id
in: body
required: true
type: string
- name: reporting_period
in: body
required: true
type: string
steps:
- name: query-performance
call:
operationId: executeQuery
input:
statement: "SELECT quality_score, cost_savings, shared_savings FROM vbc_contracts WHERE contract_id='{{contract_id}}' AND period='{{reporting_period}}'"
- name: update-account
call:
operationId: updateAccount
input:
contractId: "{{contract_id}}"
qualityScore: "{{query-performance.results}}"
consumes:
- type: http
baseUri: https://uhc-analytics.snowflakecomputing.com/api/v2
authentication:
type: bearer
token: $secrets.snowflake_token
resources:
- path: /statements
operations:
- id: executeQuery
method: POST
- type: http
baseUri: https://unitedhealth.my.salesforce.com/services/data/v58.0
authentication:
type: bearer
token: $secrets.salesforce_token
resources:
- path: /sobjects/Account
operations:
- id: updateAccount
method: PATCH
Value Based Care Performance Dashboard Sync
▼
healthcare data crm analytics
Retrieves quality measure scores from the analytics platform and updates the Salesforce Health Cloud performance dashboard.
naftiko: "0.5"
info:
title: Value-Based Care Performance Dashboard Sync
version: "1.0"
description: Retrieves quality measure scores from the analytics platform and updates the Salesforce Health Cloud performance dashboard.
tags: [healthcare, data, crm, analytics]
capability:
exposes:
type: mcp
port: 8080
tools:
- name: sync_vbc_performance
description: Pulls quality measure scores and syncs them to Salesforce Health Cloud dashboards.
inputParameters:
- name: contract_id
in: query
required: true
type: string
- name: measure_period
in: query
required: true
type: string
steps:
- name: get-measure-scores
call:
operationId: getQualityMeasures
input:
contractId: "{{contract_id}}"
period: "{{measure_period}}"
- name: update-sf-dashboard
call:
operationId: updateCarePerformanceRecord
input:
contractId: "{{contract_id}}"
scores: "{{get-measure-scores.measures}}"
period: "{{measure_period}}"
consumes:
- type: http
baseUri: https://api.optum.com/analytics/v1
authentication:
type: bearer
token: $secrets.optum_analytics_token
resources:
- path: /quality-measures
operations:
- id: getQualityMeasures
method: GET
- type: http
baseUri: https://unitedhealth.my.salesforce.com/services/data/v58.0
authentication:
type: bearer
token: $secrets.salesforce_token
resources:
- path: /sobjects/CarePerformance__c
operations:
- id: updateCarePerformanceRecord
method: POST
Vendor Invoice Processing
▼
finance procurement erp itsm
Posts a vendor invoice to SAP S/4HANA AP and routes for approval via ServiceNow workflow.
naftiko: "0.5"
info:
title: Vendor Invoice Processing
version: "1.0"
description: Posts a vendor invoice to SAP S/4HANA AP and routes for approval via ServiceNow workflow.
tags: [finance, procurement, erp, itsm]
capability:
exposes:
type: mcp
port: 8080
tools:
- name: process_vendor_invoice
description: Creates an AP invoice in SAP and creates a ServiceNow approval request.
inputParameters:
- name: vendor_id
in: body
required: true
type: string
- name: invoice_number
in: body
required: true
type: string
- name: amount
in: body
required: true
type: number
steps:
- name: post-invoice
call:
operationId: postVendorInvoice
input:
vendorId: "{{vendor_id}}"
invoiceNumber: "{{invoice_number}}"
amount: "{{amount}}"
- name: create-approval
call:
operationId: createApprovalRequest
input:
short_description: "Approve invoice {{invoice_number}} for vendor {{vendor_id}} — ${{amount}}"
category: finance
consumes:
- type: http
baseUri: https://unitedhealth-sap.example.com/sap/opu/odata/sap
authentication:
type: basic
username: $secrets.sap_user
password: $secrets.sap_password
resources:
- path: /API_SUPPLIER_INVOICE_SRV/A_SupplierInvoice
operations:
- id: postVendorInvoice
method: POST
- type: http
baseUri: https://unitedhealth.service-now.com/api/now/v1
authentication:
type: basic
username: $secrets.snow_user
password: $secrets.snow_password
resources:
- path: /table/sc_req_item
operations:
- id: createApprovalRequest
method: POST
Vision Benefit Authorization Chain
▼
claims enrollment healthcare
Processes vision benefit authorization requests through eligibility check, authorization creation, and provider notification.
naftiko: "0.5"
info:
title: Vision Benefit Authorization Chain
version: "1.0"
description: Processes vision benefit authorization requests through eligibility check, authorization creation, and provider notification.
tags: [claims, enrollment, healthcare]
capability:
exposes:
type: mcp
port: 8080
tools:
- name: authorize_vision_benefit
description: Checks vision eligibility, creates authorization, and notifies the vision provider.
inputParameters:
- name: member_id
in: body
required: true
type: string
- name: provider_npi
in: body
required: true
type: string
- name: service_type
in: body
required: true
type: string
steps:
- name: check-vision-eligibility
call:
operationId: verifyVisionEligibility
input:
memberId: "{{member_id}}"
serviceType: "{{service_type}}"
- name: create-auth
call:
operationId: createVisionAuth
input:
memberId: "{{member_id}}"
providerNpi: "{{provider_npi}}"
serviceType: "{{service_type}}"
allowance: "{{check-vision-eligibility.allowance}}"
- name: notify-provider
call:
operationId: sendTeamsMessage
input:
channelId: "vision-providers"
message: "Vision auth {{create-auth.auth_number}} created for member {{member_id}} — service: {{service_type}}."
consumes:
- type: http
baseUri: https://api.uhc.com/vision/v1
authentication:
type: bearer
token: $secrets.uhc_vision_token
resources:
- path: /eligibility
operations:
- id: verifyVisionEligibility
method: GET
- type: http
baseUri: https://api.uhc.com/vision/v1
authentication:
type: bearer
token: $secrets.uhc_vision_token
resources:
- path: /authorizations
operations:
- id: createVisionAuth
method: POST
- type: http
baseUri: https://graph.microsoft.com/v1.0
authentication:
type: bearer
token: $secrets.ms_graph_token
resources:
- path: /teams/messages
operations:
- id: sendTeamsMessage
method: POST
Workday Benefits Open Enrollment Sync
▼
enrollment human-resources workday healthcare
Synchronizes employee open enrollment selections from Workday to UHC enrollment systems and confirms via email.
naftiko: "0.5"
info:
title: Workday Benefits Open Enrollment Sync
version: "1.0"
description: Synchronizes employee open enrollment selections from Workday to UHC enrollment systems and confirms via email.
tags: [enrollment, human-resources, workday, healthcare]
capability:
exposes:
type: mcp
port: 8080
tools:
- name: sync_open_enrollment
description: Retrieves Workday benefit elections, pushes to enrollment system, and sends confirmation.
inputParameters:
- name: employee_id
in: body
required: true
type: string
- name: enrollment_period
in: body
required: true
type: string
steps:
- name: get-elections
call:
operationId: getBenefitElections
input:
employeeId: "{{employee_id}}"
period: "{{enrollment_period}}"
- name: sync-enrollment
call:
operationId: syncEnrollment
input:
employeeId: "{{employee_id}}"
elections: "{{get-elections.selections}}"
effectiveDate: "{{get-elections.effective_date}}"
- name: send-confirmation
call:
operationId: sendEmail
input:
to: "{{employee_id}}@unitedhealth.com"
subject: "Open Enrollment Confirmation"
body: "Your benefit elections for {{enrollment_period}} have been processed."
consumes:
- type: http
baseUri: https://wd5-impl-services1.workday.com/ccx/api/v1/unitedhealth
authentication:
type: bearer
token: $secrets.workday_token
resources:
- path: /benefits/elections
operations:
- id: getBenefitElections
method: GET
- type: http
baseUri: https://api.uhc.com/enrollment/v1
authentication:
type: bearer
token: $secrets.uhc_enrollment_token
resources:
- path: /sync
operations:
- id: syncEnrollment
method: POST
- type: http
baseUri: https://graph.microsoft.com/v1.0
authentication:
type: bearer
token: $secrets.ms_graph_token
resources:
- path: /me/sendMail
operations:
- id: sendEmail
method: POST
Workday Clinical Staff Onboarding
▼
human-resources clinical workday
Orchestrates onboarding for clinical staff by provisioning Workday profile, granting system access, and scheduling compliance training.
naftiko: "0.5"
info:
title: Workday Clinical Staff Onboarding
version: "1.0"
description: Orchestrates onboarding for clinical staff by provisioning Workday profile, granting system access, and scheduling compliance training.
tags: [human-resources, clinical, workday]
capability:
exposes:
type: mcp
port: 8080
tools:
- name: onboard_clinical_staff
description: Creates Workday profile, provisions system access, and assigns mandatory training modules.
inputParameters:
- name: employee_id
in: body
required: true
type: string
- name: department
in: body
required: true
type: string
- name: role
in: body
required: true
type: string
steps:
- name: create-profile
call:
operationId: createWorker
input:
employeeId: "{{employee_id}}"
department: "{{department}}"
role: "{{role}}"
- name: provision-access
call:
operationId: provisionAccess
input:
employeeId: "{{employee_id}}"
roleTemplate: "clinical_{{role}}"
- name: assign-training
call:
operationId: assignLearning
input:
employeeId: "{{employee_id}}"
courses: "HIPAA_101,Clinical_Safety,EHR_Training"
consumes:
- type: http
baseUri: https://wd5-impl-services1.workday.com/ccx/api/v1/unitedhealth
authentication:
type: bearer
token: $secrets.workday_token
resources:
- path: /workers
operations:
- id: createWorker
method: POST
- type: http
baseUri: https://unitedhealth.okta.com/api/v1
authentication:
type: bearer
token: $secrets.okta_token
resources:
- path: /apps/assignments
operations:
- id: provisionAccess
method: POST
- type: http
baseUri: https://wd5-impl-services1.workday.com/ccx/api/v1/unitedhealth
authentication:
type: bearer
token: $secrets.workday_token
resources:
- path: /learning/assignments
operations:
- id: assignLearning
method: POST