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-021621 | New member onboarding Next-best-action | Austin Lee: enrolled 2026-09-30, no activity yet |
| Proposed | — | ||
| ACT-021622 | New member onboarding Next-best-action | Rachel Roberts: enrolled 2026-09-21, no activity yet |
| Proposed | — | ||
| ACT-021623 | New member onboarding Next-best-action | Christine Porter: enrolled 2026-09-23, no activity yet |
| Proposed | — | ||
| ACT-021624 | New member onboarding Next-best-action | Fatiima Hernandez: enrolled 2026-09-06, no activity yet |
| Proposed | — | ||
| ACT-021625 | New member onboarding Next-best-action | Walter Shaw: enrolled 2026-09-24, no activity yet |
| Proposed | — | ||
| ACT-021626 | New member onboarding Next-best-action | Jeremy Burke: enrolled 2026-10-04, no activity yet |
| Proposed | — | ||
| ACT-021627 | New member onboarding Next-best-action | Romero Gregory: enrolled 2026-09-15, no activity yet |
| Proposed | — | ||
| ACT-021628 | New member onboarding Next-best-action | Heather Riichardson: enrolled 2026-10-13, no activity yet |
| Proposed | — | ||
| ACT-021629 | New member onboarding Next-best-action | Hannah Wech: enrolled 2026-10-16, no activity yet |
| Proposed | — | ||
| ACT-021630 | New member onboarding Next-best-action | Joshua Andrews: enrolled 2026-09-27, no activity yet |
| Proposed | — | ||
| ACT-021631 | New member onboarding Next-best-action | Diana Morrison: enrolled 2026-09-21, no activity yet |
| Proposed | — | ||
| ACT-021632 | New member onboarding Next-best-action | Christina Knight: enrolled 2026-09-14, no activity yet |
| Proposed | — | ||
| ACT-021633 | New member onboarding Next-best-action | Santiago Rogers: enrolled 2026-09-09, no activity yet |
| Proposed | — | ||
| ACT-021634 | New member onboarding Next-best-action | Betty Wheeler: enrolled 2026-10-16, no activity yet |
| Proposed | — | ||
| ACT-021635 | New member onboarding Next-best-action | Sandra Fuller: enrolled 2026-10-02, no activity yet |
| Proposed | — | ||
| ACT-021636 | New member onboarding Next-best-action | Jose Hoffman: enrolled 2026-10-09, no activity yet |
| Proposed | — | ||
| ACT-021637 | New member onboarding Next-best-action | Douglas Johnson: enrolled 2026-10-01, no activity yet |
| Proposed | — | ||
| ACT-021638 | New member onboarding Next-best-action | Rick Larson: enrolled 2026-10-05, no activity yet |
| Proposed | — | ||
| ACT-021639 | New member onboarding Next-best-action | Donna Willis: enrolled 2026-09-29, no activity yet |
| Proposed | — | ||
| ACT-021640 | New member onboarding Next-best-action | Yuki Mitchell: enrolled 2026-10-14, no activity yet |
| Proposed | — | ||
| ACT-021641 | New member onboarding Next-best-action | Logan Hamilton: enrolled 2026-09-16, no activity yet |
| Proposed | — | ||
| ACT-021642 | New member onboarding Next-best-action | Omar Daniels: enrolled 2026-09-19, no activity yet |
| Proposed | — | ||
| ACT-021643 | New member onboarding Next-best-action | Benjamin Hanson: enrolled 2026-09-20, no activity yet |
| Proposed | — | ||
| ACT-021644 | New member onboarding Next-best-action | Kelly Dixon: enrolled 2026-09-10, no activity yet |
| Proposed | — | ||
| ACT-021645 | New member onboarding Next-best-action | Philip Shaw: enrolled 2026-09-15, no activity yet |
| Proposed | — | ||
| ACT-021646 | New member onboarding Next-best-action | Evelyn Rjas: enrolled 2026-10-11, no activity yet |
| Proposed | — | ||
| ACT-021647 | New member onboarding Next-best-action | Sofia Scott: enrolled 2026-09-26, no activity yet |
| Proposed | — | ||
| ACT-021648 | New member onboarding Next-best-action | Janice Booyd: enrolled 2026-10-03, no activity yet |
| Proposed | — | ||
| ACT-021649 | New member onboarding Next-best-action | Albert Garza: enrolled 2026-09-27, no activity yet |
| Proposed | — | ||
| ACT-021650 | New member onboarding Next-best-action | Josua Ferguson: enrolled 2026-09-26, no activity yet |
| Proposed | — | ||
| ACT-021651 | New member onboarding Next-best-action | Amber Maldonado: enrolled 2026-09-16, no activity yet |
| Proposed | — | ||
| ACT-021652 | New member onboarding Next-best-action | Ethan Delgado: enrolled 2026-09-25, no activity yet |
| Proposed | — | ||
| ACT-021653 | New member onboarding Next-best-action | Bryan Hudson: enrolled 2026-09-18, no activity yet |
| Proposed | — | ||
| ACT-021654 | New member onboarding Next-best-action | Janice Sanders: enrolled 2026-09-13, no activity yet |
| Proposed | — | ||
| ACT-021655 | New member onboarding Next-best-action | Jeremy Andrews: enrolled 2026-09-14, no activity yet |
| Proposed | — | ||
| ACT-021656 | New member onboarding Next-best-action | Teresa Lopez: enrolled 2026-09-24, no activity yet |
| Proposed | — | ||
| ACT-021657 | New member onboarding Next-best-action | Marcus Johnston: enrolled 2026-10-11, no activity yet |
| Proposed | — | ||
| ACT-021658 | New member onboarding Next-best-action | Ryan Cruz: enrolled 2026-09-25, no activity yet |
| Proposed | — | ||
| ACT-021659 | New member onboarding Next-best-action | Medina Abigail: enrolled 2026-09-21, no activity yet |
| Proposed | — | ||
| ACT-021660 | New member onboarding Next-best-action | Katherine Washington: enrolled 2026-09-10, no activity yet |
| Proposed | — | ||
| ACT-021661 | New member onboarding Next-best-action | Carol Hoffman: enrolled 2026-10-05, no activity yet |
| Proposed | — | ||
| ACT-021662 | New member onboarding Next-best-action | Charlotte Alvarado: enrolled 2026-10-10, no activity yet |
| Proposed | — | ||
| ACT-021663 | New member onboarding Next-best-action | Alan Howell: enrolled 2026-09-09, no activity yet |
| Proposed | — | ||
| ACT-021664 | New member onboarding Next-best-action | Jonathan Franklin: enrolled 2026-09-09, no activity yet |
| Proposed | — | ||
| ACT-021665 | New member onboarding Next-best-action | Julie Evans: enrolled 2026-09-07, no activity yet |
| Proposed | — | ||
| ACT-021666 | New member onboarding Next-best-action | Nicholas Henry: enrolled 2026-09-23, 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.