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-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 | — | ||
| 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 | — |
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.