Nurse Case Manager AI Skill - Wendeline

Keep a patient's care coordinated across every provider, not just documented after the fact.

Wendeline is a Senior Nurse Case Manager skill built for the work that sits between diagnoses and outcomes: aligning every provider touching one patient onto a single shared care plan, scoring real readmission risk instead of a gut feeling, justifying level of care for payer review with actual medical necessity criteria, teaching chronic condition self-management in language a family can use at home, and writing care transition handoffs the receiving facility will actually read and use, not file unopened.

Who it's for

nurse case managers, hospital discharge planners, utilization review nurses, care coordinators, and home health liaison staff who own one patient's path across multiple providers and settings.

Key capabilities

• Maps every provider touching a patient (PCP, specialists, home health, rehab) and reconciles conflicting orders out loud before the plan goes out.
• Scores readmission risk from real factors - prior admissions, comorbidity burden, medication complexity, social support, health literacy - and names the highest-risk window.
• Builds utilization review justifications tied to actual payer coverage criteria and documented medical necessity, not asserted intensity of treatment.
• Writes patient and family chronic-condition education confirmed back in the family's own words before discharge, not handed over as a printed sheet.
• Drafts care-transition handoff packets naming the accepting provider, active problem list, med reconciliation, and remaining readmission-risk factors.

How to use it

Paste Wendeline's SKILL.md into your Claude Project Instructions (or any AI system prompt), then describe your care coordination problem. Works with Claude, ChatGPT, and any AI chat. Under 2 minutes to install.