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Healthcare Agents command center showing specialist agents across revenue cycle, compliance, quality, clinical operations, payer, health IT, population health, pharmacy, strategy, and emergency preparedness workflows

Healthcare Agents

51 specialist AI agents for US healthcare administration.
Installable prompts and skills for Claude Code, Codex, OpenCode, Cursor, Copilot, and other agentic coding tools.

Install with curl or GitHub npx 51 agents 51 of 51 agents improved Claude, Codex, OpenCode, and Cursor compatible v1.2.0 Apache 2.0 license

51
healthcare specialists
10
administrative domains
95.50
avg final-pass score
Routing + SKILL.md
usable agent formats

Healthcare Agents is a model-agnostic prompt library for healthcare administration work: revenue cycle, quality and compliance, clinical operations, payer relations, health IT, population health, pharmacy programs, operations, strategy, and emergency preparedness.

Each agent is a long-form Markdown specialist with YAML frontmatter, role-specific source awareness, compliance boundaries, operational workflows, concrete deliverable templates, best-input guidance, output modes, and cross-agent handoff rules. The pack installs into tools that support subagents, custom instructions, repository rules, or SKILL.md folders.

TL;DR

You need Healthcare Agents gives you
Healthcare-specific agent behavior 51 narrow specialists instead of one generic "healthcare assistant."
Easier agent selection Task-based chooser docs, starter prompts, output modes, and handoff maps.
Practical administrative output Appeal packets, audit binders, gap analyses, dashboards, charters, payer matrices, readiness plans, and workflow checklists.
Better regulatory handling Role-aware references to HIPAA, CMS, OIG, HEDIS, Stars, MIPS/QPP, HRSA 340B, NHSN, TEFCA, HL7/FHIR, X12, and other domain sources.
Portable installation Claude Code agents, Claude/OpenCode skills, Codex agent prompts, Cursor/Windsurf/Copilot rules, Aider context, and plain Markdown.
Prompt quality controls An included self-improvement kit with a frozen rubric, role baselines, scorer guidance, and append-only eval results.

These agents are for healthcare administration support. They are not clinicians, attorneys, auditors, coders of record, billing authorities, or a safe PHI-processing environment.

Install

Fast path:

curl -fsSL https://raw.githubusercontent.com/ajhcs/healthcare-agents/main/install.sh | bash

GitHub-backed npx:

npx --yes github:ajhcs/healthcare-agents install

The package metadata is ready for npm, but the package is not currently published to the npm registry from this environment. Use the GitHub-backed npx command above.

Target a specific tool:

Runtime Command
Claude Code subagents npx --yes github:ajhcs/healthcare-agents install --claude
Claude Skills, Claude Desktop, Claude Cowork npx --yes github:ajhcs/healthcare-agents install --claude-skills
Codex CLI / Codex App npx --yes github:ajhcs/healthcare-agents install --codex
OpenCode skills npx --yes github:ajhcs/healthcare-agents install --opencode
Open Agent Skills convention npx --yes github:ajhcs/healthcare-agents install --agent-skills
Cursor rules npx --yes github:ajhcs/healthcare-agents install --cursor
Windsurf rules npx --yes github:ajhcs/healthcare-agents install --windsurf
GitHub Copilot instructions npx --yes github:ajhcs/healthcare-agents install --copilot
All known targets npx --yes github:ajhcs/healthcare-agents install --all

Preview before writing files:

npx --yes github:ajhcs/healthcare-agents install --all --dry-run

Update existing installs:

npx --yes github:ajhcs/healthcare-agents install --all --force

Uninstall:

npx --yes github:ajhcs/healthcare-agents uninstall --all

Choose the Right Agent

Start with the task, not the agent name. Use the agent selection guide when you know the operational problem, the starter prompts when you want copy-ready examples, and the handoff map when the request spans departments.

Every agent now supports four output modes:

Ask for When to use it
quick triage Symptoms, weak data, or first-pass root cause analysis
workplan Owners, sequence, dependencies, KPIs, and timeline
audit/checklist Evidence requests, pass/fail criteria, remediation owners
artifact/template A draft work product with assumptions and placeholders

Common starting points:

You need Start with
Clean claim or denial problem revenue-cycle-specialist
Survey readiness quality-accreditation-specialist
Prior authorization delays clinical-prior-authorization-specialist
ED boarding or capacity issue operations-hospital-administrator
Interface or FHIR issue healthit-interoperability-engineer
Value-based care performance payer-value-based-care-manager
Safety event or RCA quality-patient-safety-officer
CHNA or community benefit pophealth-community-health-coordinator

Quick Examples

Claude Code:

Use the revenue-cycle-specialist agent in quick triage mode to diagnose why our clean claim rate dropped, then list coding, contract, and prior authorization handoffs.

Codex:

Read the quality-compliance-officer healthcare agent and use audit/checklist mode to draft a HIPAA Security Rule evidence checklist for a small clinic.

OpenCode:

Use the revenue-contract-analyst skill to model payer contract underpayment risk from a sample allowed-amount table.

Rules-based tools:

Using the healthit-interoperability-engineer instructions, review this HL7v2 interface mapping for common ADT and ORU risks.

Manual project install:

git clone https://github.com/ajhcs/healthcare-agents.git
mkdir -p .claude/agents
cp healthcare-agents/agents/*.md .claude/agents/

Why Use This

Generic healthcare prompting Healthcare Agents
"Follow HIPAA." Separates Privacy Rule, Security Rule, Breach Notification, minimum necessary, BAAs, operational evidence, and escalation boundaries.
"Improve revenue." Uses CARC/RARC, 837/835, charge capture, CDM, denial prevention, payer contracts, 340B, coding, and cost-report mechanics.
"Check quality." Distinguishes HEDIS, MIPS/QPP, Stars, CAHPS/HCAHPS, accreditation, patient safety, infection prevention, and QI methodology.
"Analyze healthcare data." Names FHIR, HL7v2, X12, C-CDA, Epic Caboodle/Cogito, USCDI, TEFCA, eCQMs, registries, and data-lineage controls.
"Make an operational plan." Produces healthcare-specific work products: appeal packets, readiness binders, staffing models, audit trails, gap analyses, and KPI dashboards.

Supported Tools

flowchart LR
  A["agents/*.md<br/>source prompts"] --> B["Claude Code<br/>~/.claude/agents"]
  A --> C["Codex<br/>~/.codex/agents + AGENTS.md"]
  A --> D["Rules folders<br/>Cursor · Windsurf · Copilot"]
  A --> E["Generated SKILL.md"]
  E --> F["Claude Skills<br/>Desktop · Cowork"]
  E --> G["OpenCode Skills"]
  E --> H["Open Agent Skills<br/>.agents/skills"]
Loading
Tool / Standard Install Target Notes
Claude Code subagents ~/.claude/agents/*.md Source prompts use lowercase hyphen name values matching filenames.
Claude Skills ~/.claude/skills/<slug>/SKILL.md Generated skill wrappers include name, description, license, and compatibility.
Claude Desktop / Claude Cowork Claude-compatible skills Use --claude-desktop, --claude-cowork, or --claude-skills.
Codex CLI / Codex App ~/.codex/agents/*.md plus ~/.codex/AGENTS.md Installer adds a managed discovery block telling Codex how to choose specialists, use output modes, and name handoffs.
OpenCode ~/.config/opencode/skills/<slug>/SKILL.md Matches OpenCode's skill directory conventions.
Open Agent Skills ~/.agents/skills/<slug>/SKILL.md Portable fallback for tools that scan a common .agents/skills layout.
Cursor .cursor/rules/*.md Installs the same Markdown prompts as project rules.
Windsurf .windsurf/rules/*.md Installs the same Markdown prompts as project rules.
GitHub Copilot .github/instructions/*.md Rename to .instructions.md if your Copilot setup requires that extension.
Gemini CLI ~/.gemini/agents/*.md Installs Markdown agent files globally.
Cline .clinerules/*.md Installs prompt files into project rules.
Amazon Q Developer .amazonq/rules/*.md Installs prompt files into project rules.
Continue.dev .continue/*.md Installs prompts as reusable context files.
Aider .aider.conf.yml managed read: block Adds all agent prompts as read-only context entries.

Agent Catalog

Strategy & Advisory - 5 agents
Agent Specialty
strategy-healthcare-consultant Service line planning, M&A, market analysis, CON strategy
strategy-operations-consultant Lean/Six Sigma, throughput, benchmarking, predictive operations
strategy-clinical-operations-consultant Clinical workflows, staffing models, ED/OR throughput
strategy-structural-improvement-consultant Org redesign, governance, change management, post-merger integration
strategy-actuarial-advisor Risk adjustment, capitation, IBNR, MLR, actuarial caveats
Clinical Operations - 8 agents
Agent Specialty
clinical-utilization-management-specialist Medical necessity, status, notices, InterQual/MCG boundaries
clinical-care-management-specialist Care coordination, TCM/CCM, readmission prevention, SDOH
clinical-research-coordinator IRB, ICH-GCP E6(R3), 21 CFR Part 11, trial operations
clinical-documentation-improvement-specialist CDI queries, CC/MCC capture, DRG optimization
clinical-prior-authorization-specialist PA workflows, appeals, ePA, payer/state variation
clinical-referral-specialist Referral management, network navigation, care gap closure
clinical-case-manager Discharge planning, post-acute placement, LOS optimization
clinical-infection-prevention-specialist NHSN, HAI surveillance, stewardship, outbreak response
Quality, Safety & Compliance - 7 agents
Agent Specialty
quality-improvement-specialist HEDIS, MIPS/QPP, Stars, eCQMs, SPC, Baldrige
quality-process-improvement-analyst PDSA, Lean, Six Sigma DMAIC, capability/takt math
quality-patient-experience-coordinator CAHPS/HCAHPS, service recovery, grievance escalation
quality-patient-safety-officer Sentinel events, RCA2, HFMEA, Just Culture, PSO boundaries
quality-compliance-officer HIPAA, Stark, AKS, FCA, OIG, EMTALA, CIA evidence
quality-risk-manager ERM, malpractice, claims, CRP, NPDB/state reporting boundaries
quality-accreditation-specialist TJC, NCQA, URAC, AAAHC, DNV, survey readiness
Revenue Cycle & Finance - 6 agents
Agent Specialty
revenue-cycle-specialist End-to-end RCM, denials, EDI, A/R, patient financial experience
revenue-finance-manager Budgets, reserves, CMS-2552, cost accounting, margin analysis
revenue-contract-analyst Payer contracts, fee schedules, reimbursement modeling
revenue-medical-coding-specialist ICD-10-CM/PCS, CPT, DRG, HCC, E/M, appeals
revenue-340b-program-manager Covered entity compliance, contract pharmacy, split billing, HRSA audits
revenue-chargemaster-analyst CDM maintenance, price transparency, charge capture integrity
Payer & Managed Care - 6 agents
Agent Specialty
payer-value-based-care-manager ACOs, shared savings, attribution, downside-risk readiness
payer-relations-specialist Network development, contract negotiation, No Surprises Act
payer-medicare-medicaid-specialist CMS regulations, CoPs, MAC requirements, dual-eligible programs
payer-managed-care-analyst Capitation, MLR, PMPM, network adequacy
payer-credentialing-enrollment-coordinator CAQH, PECOS, CMS-855, delegated credentialing
payer-medicare-outreach-coordinator Beneficiary education, enrollment periods, LIS/Extra Help
Health IT & Informatics - 6 agents
Agent Specialty
healthit-informatics-manager Clinical informatics, USCDI/TEFCA, ONC HTI-1, data governance
healthit-epic-applications-analyst Epic build/config, Bridges, Caboodle/Cogito
healthit-information-manager HIM operations, ROI, record retention, legal health record
healthit-clinical-data-analyst Registries, eCQMs, MIPS, SQL/Python healthcare analytics
healthit-interoperability-engineer HL7v2, FHIR R4, C-CDA, X12 EDI, HIE connectivity
healthit-telehealth-program-manager Virtual care ops, licensure, RPM/RTM, payer policy matrices
Operations & Administration - 7 agents
Agent Specialty
operations-hospital-administrator Bed management, capacity planning, throughput
operations-physician-practice-manager wRVU compensation, MGMA benchmarking, practice operations
operations-ambulatory-manager Clinic workflows, scheduling optimization, patient access
operations-home-health-administrator CoPs, OASIS, PDGM, home health VBP
operations-long-term-care-administrator SNF CoPs, MDS, PDPM, Five-Star, PBJ
operations-supply-chain-manager GPOs, value analysis, OR supplies, recalls
operations-workforce-manager Staffing models, scheduling, retention, workforce analytics
Population Health & Community - 3 agents
Agent Specialty
pophealth-population-health-manager Risk stratification, care gaps, SDOH, chronic disease programs
pophealth-surveillance-coordinator Reportable diseases, outbreak investigation, syndromic surveillance
pophealth-community-health-coordinator CHNA, Schedule H, health equity, CHW programs, grants
Pharmacy & Drug Programs - 2 agents
Agent Specialty
pharmacy-benefits-specialist Formulary, PBM contracts, specialty pharmacy, biosimilars
pharmacy-medication-safety-specialist ISMP, LASA drugs, CPOE, BCMA, USP 797/800
Emergency & Preparedness - 1 agent
Agent Specialty
emergency-preparedness-coordinator HICS, CMS EP CoPs, surge planning, HVA

Eval Status

All 51 agents have been improved through the repository's lightweight self-improvement loop.

Pass Agents Average Before Average After Delta
First before/after pass 15 85.0 93.9 +8.9
Remaining before/after pass 36 85.11 95.50 +10.40

The eval kit is intentionally simple and auditable:

File Purpose
.claude/commands/eval.md Canonical workflow for Claude Code and Codex.
eval/rubric.md Frozen scoring rubric.
eval/role-baselines/ Expected-capability baselines for all 51 agents.
eval/results.tsv Append-only results log.
docs/eval/exam-architect-playbook.md Guidance for question writing and scoring behavior.
docs/eval/model-tuning.md Model-role routing notes for current SOTA models.
eval/run-logs/ Local ignored artifacts for exact questions, scorer outputs, editor briefs, and summaries.

Same-question before/after comparisons must preserve full Q001-Q025 artifacts before answers are generated. This keeps score deltas tied to the exact same exam rather than paraphrased weak areas.

Self-Improvement Kit

Install the eval loop into another project that already has agents/*.md:

git clone https://github.com/ajhcs/healthcare-agents.git
bash healthcare-agents/scripts/install-self-improvement-kit.sh /path/to/project

Run in Claude Code:

/eval revenue-medical-coding-specialist

Run in Codex:

Run the healthcare self-improvement loop for revenue-medical-coding-specialist.

During a normal eval run, only the requested agents/<slug>.md file should change, eval/results.tsv should only receive appended rows, and local artifacts should stay under ignored eval/run-logs/ paths.

Repository Layout

.
├── agents/                         # 51 source agent prompts
├── .claude/commands/eval.md         # canonical self-improvement workflow
├── eval/
│   ├── rubric.md                    # frozen scoring rubric
│   ├── results.tsv                  # append-only eval log
│   ├── role-baselines/              # expected capability baselines
│   └── run-logs/                    # local ignored exact-question artifacts
├── docs/eval/                       # scorer and model-routing guidance
├── docs/usage/                      # agent chooser, starter prompts, handoff map
├── bin/cli.js                       # GitHub-backed npx entrypoint
├── install.sh                       # multi-tool installer
└── scripts/                         # lint and self-improvement kit helpers

Validation

Validate agent prompt structure:

bash scripts/lint-agents.sh

Preview installer behavior:

bash install.sh --all --dry-run

Check CLI help:

npx --yes github:ajhcs/healthcare-agents --help

Limitations

  • The agents provide healthcare administration support, not final clinical, legal, coding, billing, audit, or compliance determinations.
  • Regulations, code sets, payer policies, accreditation standards, and program manuals change. Verify against current primary sources before operational use.
  • The prompts do not make an AI tool HIPAA-compliant and do not create a safe PHI-processing environment. Use approved privacy, security, de-identification, and vendor-review workflows.
  • Tool support differs by runtime. The installer uses best-known current file layouts and keeps plain Markdown as the fallback.
  • The eval scores measure performance against this repository's rubric and role baselines; they are not external certification.

Troubleshooting

Problem Fix
npx healthcare-agents cannot find the package Use npx --yes github:ajhcs/healthcare-agents install; the npm package is not published yet.
Existing files are skipped Re-run with --force after reviewing --dry-run output.
Your tool does not auto-discover the agents Install to a custom path with --path <dir> or copy the relevant agents/<slug>.md file into the tool's documented rule/context folder.
Claude/OpenCode rejects a skill name Use v1.1.1 or newer; agent and skill names are lowercase hyphen slugs.
You only want one agent Copy the specific agents/<slug>.md file or generated SKILL.md folder manually. The installer is pack-oriented.

FAQ

Are these Claude Code agents or skills?

Both. The source files in agents/*.md install as Claude Code subagents. The installer can also generate one SKILL.md folder per agent for Claude Skills, Claude Desktop/Cowork where skills are available, OpenCode, and the open .agents/skills convention.

Do these work in Codex?

Yes. The installer copies prompts to ~/.codex/agents and writes a managed ~/.codex/AGENTS.md block telling Codex how to select and read specialists. For repo-local Codex App work, keep the prompts in the repository and reference them from AGENTS.md.

Why did the frontmatter names change?

Claude Code and OpenCode expect lowercase hyphen identifiers. v1.1.1 and newer keep human labels in display_name while making name match the filename slug.

Can I use these for HIPAA, coding, payer, or compliance work?

Use them for structured analysis, checklists, source-aware workflows, and draft deliverables. Do not treat them as final legal, clinical, coding, billing, audit, or compliance determinations.

Can I use these with PHI?

Only inside an environment your organization has approved for PHI, with the right vendor agreements, access controls, retention settings, and de-identification practices. The prompts themselves do not solve that governance problem.

Can I add my own agents?

Yes. Follow the conventions in CONTRIBUTING.md, run bash scripts/lint-agents.sh, and keep the agent narrow, source-aware, and operationally concrete.

License

Apache 2.0. See LICENSE.

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Portable prompt and SKILL.md pack with 51 specialist AI agents for US healthcare administration workflows.

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