Operate, actions
Actions
Downstream actions derived from the resolved identities. Proposed actions wait for an operator; suppressed actions wait for a steward decision.
Eligibility engine
1,339
Eligibility conflict resolved
1,339 proposed
Claims processor
9,112
Orphan claim re-pointed
9,112 executed
Outreach
7,319
Outreach address corrected, Outreach suppressed pending steward
2,993 proposed4,326 held
Next-best-action
3,896
Care coordination outreach, New member onboarding
3,896 proposed
Member services
4,974
Duplicate member record retired
4,974 executed
Actions
26,640 derived from the last resolution run
| Action | Type | Title | Detail | Linked to | Status | Executed | |
|---|---|---|---|---|---|---|---|
| ACT-019871 | New member onboarding Next-best-action | Lori Hansen: enrolled 2026-10-14, no activity yet |
| Proposed | — | ||
| ACT-019872 | New member onboarding Next-best-action | Luis Perry: enrolled 2026-10-14, no activity yet |
| Proposed | — | ||
| ACT-019873 | New member onboarding Next-best-action | Shirley Peters: enrolled 2026-10-03, no activity yet |
| Proposed | — | ||
| ACT-019874 | New member onboarding Next-best-action | Donna Scott: enrolled 2026-10-13, no activity yet |
| Proposed | — | ||
| ACT-019875 | New member onboarding Next-best-action | Ann Rodriguez: enrolled 2026-10-14, no activity yet |
| Proposed | — | ||
| ACT-019876 | New member onboarding Next-best-action | Sophia Cooper: enrolled 2026-10-11, no activity yet |
| Proposed | — | ||
| ACT-019877 | New member onboarding Next-best-action | Janet Bishop: enrolled 2026-09-10, no activity yet |
| Proposed | — | ||
| ACT-019878 | New member onboarding Next-best-action | Adma Webb: enrolled 2026-09-05, no activity yet |
| Proposed | — | ||
| ACT-019879 | New member onboarding Next-best-action | Kevin Le: enrolled 2026-09-17, no activity yet |
| Proposed | — | ||
| ACT-019880 | New member onboarding Next-best-action | Debra Duncan: enrolled 2026-10-05, no activity yet |
| Proposed | — | ||
| ACT-019881 | New member onboarding Next-best-action | Grace Stephens: enrolled 2026-09-09, no activity yet |
| Proposed | — | ||
| ACT-019882 | New member onboarding Next-best-action | Madison Nguyen: enrolled 2026-10-02, no activity yet |
| Proposed | — | ||
| ACT-019883 | New member onboarding Next-best-action | Theresa Foser: enrolled 2026-09-10, no activity yet |
| Proposed | — | ||
| ACT-019884 | New member onboarding Next-best-action | Carlos Greene: enrolled 2026-10-13, no activity yet |
| Proposed | — | ||
| ACT-019885 | New member onboarding Next-best-action | Harold Lna: enrolled 2026-09-07, no activity yet |
| Proposed | — | ||
| ACT-019886 | New member onboarding Next-best-action | Maria Wells: enrolled 2026-09-06, no activity yet |
| Proposed | — | ||
| ACT-019887 | New member onboarding Next-best-action | Scott Santos: enrolled 2026-10-04, no activity yet |
| Proposed | — | ||
| ACT-019888 | New member onboarding Next-best-action | Roy Mendez: enrolled 2026-09-05, no activity yet |
| Proposed | — | ||
| ACT-019889 | New member onboarding Next-best-action | Hannah Crawford: enrolled 2026-09-06, no activity yet |
| Proposed | — | ||
| ACT-019890 | New member onboarding Next-best-action | Alan Wright: enrolled 2026-09-14, no activity yet |
| Proposed | — | ||
| ACT-019891 | New member onboarding Next-best-action | Zachary Snyder: enrolled 2026-10-11, no activity yet |
| Proposed | — | ||
| ACT-019892 | New member onboarding Next-best-action | Carlos Hunter: enrolled 2026-10-12, no activity yet |
| Proposed | — | ||
| ACT-019893 | New member onboarding Next-best-action | Bell Melissa: enrolled 2026-09-13, no activity yet |
| Proposed | — | ||
| ACT-019894 | New member onboarding Next-best-action | Jaun Carroll: enrolled 2026-10-11, no activity yet |
| Proposed | — | ||
| ACT-019895 | New member onboarding Next-best-action | Sofai Phillips: enrolled 2026-10-02, no activity yet |
| Proposed | — | ||
| ACT-019896 | New member onboarding Next-best-action | Nicole Austin: enrolled 2026-10-15, no activity yet |
| Proposed | — | ||
| ACT-019897 | New member onboarding Next-best-action | Martha Brown: enrolled 2026-09-19, no activity yet |
| Proposed | — | ||
| ACT-019898 | New member onboarding Next-best-action | Anthony Patterson: enrolled 2026-09-09, no activity yet |
| Proposed | — | ||
| ACT-019899 | New member onboarding Next-best-action | Teresa Stevens: enrolled 2026-09-22, no activity yet |
| Proposed | — | ||
| ACT-019900 | New member onboarding Next-best-action | Mason Chavez: enrolled 2026-10-14, no activity yet |
| Proposed | — | ||
| ACT-019901 | New member onboarding Next-best-action | Ronald Saanchez: enrolled 2026-10-18, no activity yet |
| Proposed | — | ||
| ACT-019902 | New member onboarding Next-best-action | Kyle Peterson: enrolled 2026-09-14, no activity yet |
| Proposed | — | ||
| ACT-019903 | New member onboarding Next-best-action | Scott Carroll: enrolled 2026-09-25, no activity yet |
| Proposed | — | ||
| ACT-019904 | New member onboarding Next-best-action | Alexander Nunez: enrolled 2026-10-12, no activity yet |
| Proposed | — | ||
| ACT-019905 | New member onboarding Next-best-action | Logan Schultz: enrolled 2026-09-05, no activity yet |
| Proposed | — | ||
| ACT-019906 | New member onboarding Next-best-action | Doris Mejia: enrolled 2026-09-21, no activity yet |
| Proposed | — | ||
| ACT-019907 | New member onboarding Next-best-action | Thomas Hudson: enrolled 2026-10-02, no activity yet |
| Proposed | — | ||
| ACT-019908 | New member onboarding Next-best-action | Brandon Ortiz: enrolled 2026-10-04, no activity yet |
| Proposed | — | ||
| ACT-019909 | New member onboarding Next-best-action | Lawrence Romero: enrolled 2026-09-14, no activity yet |
| Proposed | — | ||
| ACT-019910 | New member onboarding Next-best-action | Kimberly Fernandez: enrolled 2026-10-09, no activity yet |
| Proposed | — | ||
| ACT-019911 | New member onboarding Next-best-action | Henry Adams: enrolled 2026-10-09, no activity yet |
| Proposed | — | ||
| ACT-019912 | New member onboarding Next-best-action | Donna Campbell: enrolled 2026-09-28, no activity yet |
| Proposed | — | ||
| ACT-019913 | New member onboarding Next-best-action | Judith Howard: enrolled 2026-09-07, no activity yet |
| Proposed | — | ||
| ACT-019914 | New member onboarding Next-best-action | Sarah Munoz: enrolled 2026-09-23, no activity yet |
| Proposed | — | ||
| ACT-019915 | New member onboarding Next-best-action | Hiroshi Dunn: enrolled 2026-10-18, no activity yet |
| Proposed | — | ||
| ACT-019916 | New member onboarding Next-best-action | Nancy Silva: enrolled 2026-10-03, no activity yet |
| Proposed | — | ||
| ACT-019917 | New member onboarding Next-best-action | Lawrence Mason: enrolled 2026-09-23, no activity yet |
| Proposed | — | ||
| ACT-019918 | New member onboarding Next-best-action | Linda Scott: enrolled 2026-10-10, no activity yet |
| Proposed | — | ||
| ACT-019919 | New member onboarding Next-best-action | Sophia Edwards: enrolled 2026-09-13, no activity yet |
| Proposed | — | ||
| ACT-019920 | New member onboarding Next-best-action | Jessica Lane: enrolled 2026-09-30, no activity yet |
| Proposed | — |
Derivation rules
Evaluated after every gold rebuild
- 1Eligibility conflict resolvedThe records behind one identity disagree on plan code. Survivorship picks the enrollment plan; the eligibility engine is told which one is canonical.
- 2Orphan claim re-pointedA claim arrived without a member ID. Resolution attached it to an identity that has one, so the claims processor can now pay it against the right member.
- 3Outreach address correctedThe most recent address on the golden record differs from what enrollment holds. Outreach gets the current address before the next mailing.
- 4Outreach suppressed pending stewardThe record is sitting in an open steward case. Nothing sensitive is sent until a person decides, so we never message the wrong member.
- 5Care coordination outreachThree or more claims and no provider record. Next-best-action proposes assigning a PCP and scheduling a care-coordination call.
- 6New member onboardingA single, fresh enrollment with no other activity yet. Next-best-action proposes the welcome kit and a digital ID card.
- 7Duplicate member record retiredTwo or more enrollment records collapsed into one identity. Member services retires the extra cards against the surviving member ID.