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-020321 | New member onboarding Next-best-action | Charlotte Fowler: enrolled 2026-09-09, no activity yet |
| Proposed | — | ||
| ACT-020322 | New member onboarding Next-best-action | Noah Bailey: enrolled 2026-09-21, no activity yet |
| Proposed | — | ||
| ACT-020323 | New member onboarding Next-best-action | Sharon Day: enrolled 2026-10-03, no activity yet |
| Proposed | — | ||
| ACT-020324 | New member onboarding Next-best-action | Sarah Bowman: enrolled 2026-09-25, no activity yet |
| Proposed | — | ||
| ACT-020325 | New member onboarding Next-best-action | David Boyd: enrolled 2026-09-27, no activity yet |
| Proposed | — | ||
| ACT-020326 | New member onboarding Next-best-action | Karen Ryan: enrolled 2026-09-30, no activity yet |
| Proposed | — | ||
| ACT-020327 | New member onboarding Next-best-action | Patricia Murray: enrolled 2026-09-15, no activity yet |
| Proposed | — | ||
| ACT-020328 | New member onboarding Next-best-action | Tomas Wells: enrolled 2026-09-15, no activity yet |
| Proposed | — | ||
| ACT-020329 | New member onboarding Next-best-action | Mateo Ray: enrolled 2026-09-30, no activity yet |
| Proposed | — | ||
| ACT-020330 | New member onboarding Next-best-action | Judith Brown: enrolled 2026-10-08, no activity yet |
| Proposed | — | ||
| ACT-020331 | New member onboarding Next-best-action | Michael Gardner: enrolled 2026-10-15, no activity yet |
| Proposed | — | ||
| ACT-020332 | New member onboarding Next-best-action | Sam Padilla: enrolled 2026-09-16, no activity yet |
| Proposed | — | ||
| ACT-020333 | New member onboarding Next-best-action | Sandra Jimenez: enrolled 2026-10-14, no activity yet |
| Proposed | — | ||
| ACT-020334 | New member onboarding Next-best-action | George Berry: enrolled 2026-10-15, no activity yet |
| Proposed | — | ||
| ACT-020335 | New member onboarding Next-best-action | Maria Bradley: enrolled 2026-09-05, no activity yet |
| Proposed | — | ||
| ACT-020336 | New member onboarding Next-best-action | Christine Simpson: enrolled 2026-10-15, no activity yet |
| Proposed | — | ||
| ACT-020337 | New member onboarding Next-best-action | Carol Marshall: enrolled 2026-09-27, no activity yet |
| Proposed | — | ||
| ACT-020338 | New member onboarding Next-best-action | Amber Tran: enrolled 2026-09-29, no activity yet |
| Proposed | — | ||
| ACT-020339 | New member onboarding Next-best-action | Ryan Parker: enrolled 2026-09-30, no activity yet |
| Proposed | — | ||
| ACT-020340 | New member onboarding Next-best-action | Evelyn Rojsa: enrolled 2026-10-11, no activity yet |
| Proposed | — | ||
| ACT-020341 | New member onboarding Next-best-action | Thompson Gary: enrolled 2026-10-06, no activity yet |
| Proposed | — | ||
| ACT-020342 | New member onboarding Next-best-action | Tyler Warren: enrolled 2026-09-21, no activity yet |
| Proposed | — | ||
| ACT-020343 | New member onboarding Next-best-action | Raymond Franklin: enrolled 2026-09-30, no activity yet |
| Proposed | — | ||
| ACT-020344 | New member onboarding Next-best-action | Amber Chapman: enrolled 2026-10-17, no activity yet |
| Proposed | — | ||
| ACT-020345 | New member onboarding Next-best-action | Maria Gonzales: enrolled 2026-10-11, no activity yet |
| Proposed | — | ||
| ACT-020346 | New member onboarding Next-best-action | Cheryl Scott: enrolled 2026-09-15, no activity yet |
| Proposed | — | ||
| ACT-020347 | New member onboarding Next-best-action | Patrick Sullivan: enrolled 2026-09-05, no activity yet |
| Proposed | — | ||
| ACT-020348 | New member onboarding Next-best-action | Jose Boyd: enrolled 2026-10-16, no activity yet |
| Proposed | — | ||
| ACT-020349 | New member onboarding Next-best-action | Cheryl Ford: enrolled 2026-10-09, no activity yet |
| Proposed | — | ||
| ACT-020350 | New member onboarding Next-best-action | Omar Hamilton: enrolled 2026-10-15, no activity yet |
| Proposed | — | ||
| ACT-020351 | New member onboarding Next-best-action | Gary Willis: enrolled 2026-10-08, no activity yet |
| Proposed | — | ||
| ACT-020352 | New member onboarding Next-best-action | Weber Brittany: enrolled 2026-10-04, no activity yet |
| Proposed | — | ||
| ACT-020353 | New member onboarding Next-best-action | Phillip Barnes: enrolled 2026-10-10, no activity yet |
| Proposed | — | ||
| ACT-020354 | New member onboarding Next-best-action | Vincent Wilson: enrolled 2026-09-07, no activity yet |
| Proposed | — | ||
| ACT-020355 | New member onboarding Next-best-action | Frances Harper: enrolled 2026-09-13, no activity yet |
| Proposed | — | ||
| ACT-020356 | New member onboarding Next-best-action | Dennis Graham: enrolled 2026-10-08, no activity yet |
| Proposed | — | ||
| ACT-020357 | New member onboarding Next-best-action | Peter Johnson: enrolled 2026-10-18, no activity yet |
| Proposed | — | ||
| ACT-020358 | New member onboarding Next-best-action | Cheryl Larson: enrolled 2026-10-04, no activity yet |
| Proposed | — | ||
| ACT-020359 | New member onboarding Next-best-action | Lisa West: enrolled 2026-09-24, no activity yet |
| Proposed | — | ||
| ACT-020360 | New member onboarding Next-best-action | Catherine Jimenez: enrolled 2026-09-11, no activity yet |
| Proposed | — | ||
| ACT-020361 | New member onboarding Next-best-action | Matthwe Burke: enrolled 2026-10-12, no activity yet |
| Proposed | — | ||
| ACT-020362 | New member onboarding Next-best-action | Yuki Jones: enrolled 2026-09-15, no activity yet |
| Proposed | — | ||
| ACT-020363 | New member onboarding Next-best-action | Joe Ferguson: enrolled 2026-10-08, no activity yet |
| Proposed | — | ||
| ACT-020364 | New member onboarding Next-best-action | Kim Kelly: enrolled 2026-10-09, no activity yet |
| Proposed | — | ||
| ACT-020365 | New member onboarding Next-best-action | Sean Wong: enrolled 2026-10-17, no activity yet |
| Proposed | — | ||
| ACT-020366 | New member onboarding Next-best-action | Michelle Nguyen: enrolled 2026-10-17, no activity yet |
| Proposed | — | ||
| ACT-020367 | New member onboarding Next-best-action | Johnston Dennis: enrolled 2026-09-21, no activity yet |
| Proposed | — | ||
| ACT-020368 | New member onboarding Next-best-action | Mary Bell: enrolled 2026-10-11, no activity yet |
| Proposed | — | ||
| ACT-020369 | New member onboarding Next-best-action | Noah Bowman: enrolled 2026-09-28, no activity yet |
| Proposed | — | ||
| ACT-020370 | New member onboarding Next-best-action | Janet Dominguez: enrolled 2026-09-12, 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.