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-020089 | New member onboarding Next-best-action | Hiroshi Sandoval: enrolled 2026-09-06, no activity yet |
| Proposed | — | ||
| ACT-020090 | New member onboarding Next-best-action | Emily Gibson: enrolled 2026-09-17, no activity yet |
| Proposed | — | ||
| ACT-020091 | New member onboarding Next-best-action | Arthur Ryan: enrolled 2026-10-07, no activity yet |
| Proposed | — | ||
| ACT-020092 | New member onboarding Next-best-action | Carol Nguyen: enrolled 2026-10-04, no activity yet |
| Proposed | — | ||
| ACT-020093 | New member onboarding Next-best-action | Tyler Cooper: enrolled 2026-09-06, no activity yet |
| Proposed | — | ||
| ACT-020094 | New member onboarding Next-best-action | Amber Morris: enrolled 2026-10-05, no activity yet |
| Proposed | — | ||
| ACT-020095 | New member onboarding Next-best-action | Susan Ramos: enrolled 2026-10-18, no activity yet |
| Proposed | — | ||
| ACT-020096 | New member onboarding Next-best-action | Catherine Woods: enrolled 2026-09-16, no activity yet |
| Proposed | — | ||
| ACT-020097 | New member onboarding Next-best-action | George Howell: enrolled 2026-10-12, no activity yet |
| Proposed | — | ||
| ACT-020098 | New member onboarding Next-best-action | Carol Thompson: enrolled 2026-09-24, no activity yet |
| Proposed | — | ||
| ACT-020099 | New member onboarding Next-best-action | Kayla Lewis: enrolled 2026-09-18, no activity yet |
| Proposed | — | ||
| ACT-020100 | New member onboarding Next-best-action | Noah Estrada: enrolled 2026-09-16, no activity yet |
| Proposed | — | ||
| ACT-020101 | New member onboarding Next-best-action | Lauren Peters: enrolled 2026-10-09, no activity yet |
| Proposed | — | ||
| ACT-020102 | New member onboarding Next-best-action | Sharon Brooks: enrolled 2026-09-16, no activity yet |
| Proposed | — | ||
| ACT-020103 | New member onboarding Next-best-action | Amber Russell: enrolled 2026-09-20, no activity yet |
| Proposed | — | ||
| ACT-020104 | New member onboarding Next-best-action | Adam Anderson: enrolled 2026-09-13, no activity yet |
| Proposed | — | ||
| ACT-020105 | New member onboarding Next-best-action | Alan Shaw: enrolled 2026-10-03, no activity yet |
| Proposed | — | ||
| ACT-020106 | New member onboarding Next-best-action | Sean Jordan: enrolled 2026-09-20, no activity yet |
| Proposed | — | ||
| ACT-020107 | New member onboarding Next-best-action | Thoas Sanders: enrolled 2026-09-23, no activity yet |
| Proposed | — | ||
| ACT-020108 | New member onboarding Next-best-action | Melissa Deelgado: enrolled 2026-10-17, no activity yet |
| Proposed | — | ||
| ACT-020109 | New member onboarding Next-best-action | Billy Chapman: enrolled 2026-09-23, no activity yet |
| Proposed | — | ||
| ACT-020110 | New member onboarding Next-best-action | Edward Ross: enrolled 2026-10-10, no activity yet |
| Proposed | — | ||
| ACT-020111 | New member onboarding Next-best-action | Joe Evans: enrolled 2026-10-08, no activity yet |
| Proposed | — | ||
| ACT-020112 | New member onboarding Next-best-action | Douglas Matthews: enrolled 2026-10-09, no activity yet |
| Proposed | — | ||
| ACT-020113 | New member onboarding Next-best-action | Ronald Moreno: enrolled 2026-09-08, no activity yet |
| Proposed | — | ||
| ACT-020114 | New member onboarding Next-best-action | Kathryn Edwards: enrolled 2026-09-22, no activity yet |
| Proposed | — | ||
| ACT-020115 | New member onboarding Next-best-action | Sarrah Obrien: enrolled 2026-09-10, no activity yet |
| Proposed | — | ||
| ACT-020116 | New member onboarding Next-best-action | Sandra Dean: enrolled 2026-09-29, no activity yet |
| Proposed | — | ||
| ACT-020117 | New member onboarding Next-best-action | Adam Webb: enrolled 2026-09-07, no activity yet |
| Proposed | — | ||
| ACT-020118 | New member onboarding Next-best-action | Sofia Gilbert: enrolled 2026-09-15, no activity yet |
| Proposed | — | ||
| ACT-020119 | New member onboarding Next-best-action | Jacqueline Salazar: enrolled 2026-09-27, no activity yet |
| Proposed | — | ||
| ACT-020120 | New member onboarding Next-best-action | Ray Grant: enrolled 2026-09-24, no activity yet |
| Proposed | — | ||
| ACT-020121 | New member onboarding Next-best-action | George Chavez: enrolled 2026-09-26, no activity yet |
| Proposed | — | ||
| ACT-020122 | New member onboarding Next-best-action | Omar Reid: enrolled 2026-09-14, no activity yet |
| Proposed | — | ||
| ACT-020123 | New member onboarding Next-best-action | Debra Henry: enrolled 2026-09-19, no activity yet |
| Proposed | — | ||
| ACT-020124 | New member onboarding Next-best-action | Mary Simmons: enrolled 2026-10-06, no activity yet |
| Proposed | — | ||
| ACT-020125 | New member onboarding Next-best-action | Danielle Gray: enrolled 2026-10-07, no activity yet |
| Proposed | — | ||
| ACT-020126 | New member onboarding Next-best-action | Christopher Patterson: enrolled 2026-09-27, no activity yet |
| Proposed | — | ||
| ACT-020127 | New member onboarding Next-best-action | Larry Vazquez: enrolled 2026-09-20, no activity yet |
| Proposed | — | ||
| ACT-020128 | New member onboarding Next-best-action | Lauren Hanon: enrolled 2026-09-06, no activity yet |
| Proposed | — | ||
| ACT-020129 | New member onboarding Next-best-action | Juan Rodriguez: enrolled 2026-09-18, no activity yet |
| Proposed | — | ||
| ACT-020130 | New member onboarding Next-best-action | Justin West: enrolled 2026-09-10, no activity yet |
| Proposed | — | ||
| ACT-020131 | New member onboarding Next-best-action | Juan Cooper: enrolled 2026-09-14, no activity yet |
| Proposed | — | ||
| ACT-020132 | New member onboarding Next-best-action | Carol Chapman: enrolled 2026-10-01, no activity yet |
| Proposed | — | ||
| ACT-020133 | New member onboarding Next-best-action | Alan Payne: enrolled 2026-09-17, no activity yet |
| Proposed | — | ||
| ACT-020134 | New member onboarding Next-best-action | Keith White: enrolled 2026-09-29, no activity yet |
| Proposed | — | ||
| ACT-020135 | New member onboarding Next-best-action | Roger Contreras: enrolled 2026-09-28, no activity yet |
| Proposed | — | ||
| ACT-020136 | New member onboarding Next-best-action | Jacob Patel: enrolled 2026-09-13, no activity yet |
| Proposed | — | ||
| ACT-020137 | New member onboarding Next-best-action | Kathleen Santiago: enrolled 2026-09-19, no activity yet |
| Proposed | — | ||
| ACT-020138 | New member onboarding Next-best-action | Scott Lopez: 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.