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-020271 | New member onboarding Next-best-action | Jerry Hughes: enrolled 2026-10-14, no activity yet |
| Proposed | — | ||
| ACT-020272 | New member onboarding Next-best-action | Logan Richardson: enrolled 2026-09-26, no activity yet |
| Proposed | — | ||
| ACT-020273 | New member onboarding Next-best-action | Andrew Ramirez: enrolled 2026-10-01, no activity yet |
| Proposed | — | ||
| ACT-020274 | New member onboarding Next-best-action | Noah Ford: enrolled 2026-10-05, no activity yet |
| Proposed | — | ||
| ACT-020275 | New member onboarding Next-best-action | Emma Rios: enrolled 2026-09-12, no activity yet |
| Proposed | — | ||
| ACT-020276 | New member onboarding Next-best-action | Santiago Gutierrez: enrolled 2026-09-24, no activity yet |
| Proposed | — | ||
| ACT-020277 | New member onboarding Next-best-action | Helen Jacobs: enrolled 2026-10-06, no activity yet |
| Proposed | — | ||
| ACT-020278 | New member onboarding Next-best-action | Mariana Roberts: enrolled 2026-10-03, no activity yet |
| Proposed | — | ||
| ACT-020279 | New member onboarding Next-best-action | Gloria Hall: enrolled 2026-10-04, no activity yet |
| Proposed | — | ||
| ACT-020280 | New member onboarding Next-best-action | Aaron Vargas: enrolled 2026-09-10, no activity yet |
| Proposed | — | ||
| ACT-020281 | New member onboarding Next-best-action | Hannah Gilbert: enrolled 2026-10-15, no activity yet |
| Proposed | — | ||
| ACT-020282 | New member onboarding Next-best-action | Lori Kelly: enrolled 2026-10-17, no activity yet |
| Proposed | — | ||
| ACT-020283 | New member onboarding Next-best-action | Adam Sanduval: enrolled 2026-09-10, no activity yet |
| Proposed | — | ||
| ACT-020284 | New member onboarding Next-best-action | Melissa Willis: enrolled 2026-09-26, no activity yet |
| Proposed | — | ||
| ACT-020285 | New member onboarding Next-best-action | Doris Delgado: enrolled 2026-09-18, no activity yet |
| Proposed | — | ||
| ACT-020286 | New member onboarding Next-best-action | Marcus Nichols: enrolled 2026-10-06, no activity yet |
| Proposed | — | ||
| ACT-020287 | New member onboarding Next-best-action | Emily Kelly: enrolled 2026-09-14, no activity yet |
| Proposed | — | ||
| ACT-020288 | New member onboarding Next-best-action | Howell Michael: enrolled 2026-09-19, no activity yet |
| Proposed | — | ||
| ACT-020289 | New member onboarding Next-best-action | Hiroshi Herrera: enrolled 2026-09-07, no activity yet |
| Proposed | — | ||
| ACT-020290 | New member onboarding Next-best-action | Madison Obrien: enrolled 2026-10-03, no activity yet |
| Proposed | — | ||
| ACT-020291 | New member onboarding Next-best-action | Bradley Murphy: enrolled 2026-10-06, no activity yet |
| Proposed | — | ||
| ACT-020292 | New member onboarding Next-best-action | Carolyn Hernandez: enrolled 2026-09-17, no activity yet |
| Proposed | — | ||
| ACT-020293 | New member onboarding Next-best-action | Jennifer Fernandez: enrolled 2026-09-08, no activity yet |
| Proposed | — | ||
| ACT-020294 | New member onboarding Next-best-action | Harold Herrerra: enrolled 2026-10-03, no activity yet |
| Proposed | — | ||
| ACT-020295 | New member onboarding Next-best-action | Yuki Fernandez: enrolled 2026-10-13, no activity yet |
| Proposed | — | ||
| ACT-020296 | New member onboarding Next-best-action | Roger Moreno: enrolled 2026-10-10, no activity yet |
| Proposed | — | ||
| ACT-020297 | New member onboarding Next-best-action | Valentina Powell: enrolled 2026-09-24, no activity yet |
| Proposed | — | ||
| ACT-020298 | New member onboarding Next-best-action | Kelly Edwards: enrolled 2026-10-11, no activity yet |
| Proposed | — | ||
| ACT-020299 | New member onboarding Next-best-action | Chuck Cooper: enrolled 2026-09-18, no activity yet |
| Proposed | — | ||
| ACT-020300 | New member onboarding Next-best-action | Vincent Chapman: enrolled 2026-10-09, no activity yet |
| Proposed | — | ||
| ACT-020301 | New member onboarding Next-best-action | Ema Thomas: enrolled 2026-09-05, no activity yet |
| Proposed | — | ||
| ACT-020302 | New member onboarding Next-best-action | Virgginia Welch: enrolled 2026-09-10, no activity yet |
| Proposed | — | ||
| ACT-020303 | New member onboarding Next-best-action | Thomas Hawkins: enrolled 2026-10-14, no activity yet |
| Proposed | — | ||
| ACT-020304 | New member onboarding Next-best-action | Camila Hamilton: enrolled 2026-10-18, no activity yet |
| Proposed | — | ||
| ACT-020305 | New member onboarding Next-best-action | Ethan Wood: enrolled 2026-09-12, no activity yet |
| Proposed | — | ||
| ACT-020306 | New member onboarding Next-best-action | Charlotte Gray: enrolled 2026-09-13, no activity yet |
| Proposed | — | ||
| ACT-020307 | New member onboarding Next-best-action | Pteer Carroll: enrolled 2026-09-07, no activity yet |
| Proposed | — | ||
| ACT-020308 | New member onboarding Next-best-action | Sandra Lawson: enrolled 2026-10-16, no activity yet |
| Proposed | — | ||
| ACT-020309 | New member onboarding Next-best-action | Kye Young: enrolled 2026-09-07, no activity yet |
| Proposed | — | ||
| ACT-020310 | New member onboarding Next-best-action | Ronald Taylor: enrolled 2026-09-28, no activity yet |
| Proposed | — | ||
| ACT-020311 | New member onboarding Next-best-action | Marrilyn Wells: enrolled 2026-10-08, no activity yet |
| Proposed | — | ||
| ACT-020312 | New member onboarding Next-best-action | Maldonado John: enrolled 2026-10-18, no activity yet |
| Proposed | — | ||
| ACT-020313 | New member onboarding Next-best-action | Susan Johnson: enrolled 2026-10-18, no activity yet |
| Proposed | — | ||
| ACT-020314 | New member onboarding Next-best-action | Amy Park: enrolled 2026-10-15, no activity yet |
| Proposed | — | ||
| ACT-020315 | New member onboarding Next-best-action | Don Kim: enrolled 2026-09-22, no activity yet |
| Proposed | — | ||
| ACT-020316 | New member onboarding Next-best-action | Brenda Arnold: enrolled 2026-09-14, no activity yet |
| Proposed | — | ||
| ACT-020317 | New member onboarding Next-best-action | Diego Bowman: enrolled 2026-09-23, no activity yet |
| Proposed | — | ||
| ACT-020318 | New member onboarding Next-best-action | Sandra Murray: enrolled 2026-10-08, no activity yet |
| Proposed | — | ||
| ACT-020319 | New member onboarding Next-best-action | Banks William: enrolled 2026-10-16, no activity yet |
| Proposed | — | ||
| ACT-020320 | New member onboarding Next-best-action | James Watkins: 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.