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-021039 | New member onboarding Next-best-action | Cynthia Sandoval: enrolled 2026-10-03, no activity yet |
| Proposed | — | ||
| ACT-021040 | New member onboarding Next-best-action | Terry Arnold: enrolled 2026-09-06, no activity yet |
| Proposed | — | ||
| ACT-021041 | New member onboarding Next-best-action | Luis Kennedy: enrolled 2026-09-13, no activity yet |
| Proposed | — | ||
| ACT-021042 | New member onboarding Next-best-action | Willie Nichols: enrolled 2026-09-16, no activity yet |
| Proposed | — | ||
| ACT-021043 | New member onboarding Next-best-action | Carl Allen: enrolled 2026-09-20, no activity yet |
| Proposed | — | ||
| ACT-021044 | New member onboarding Next-best-action | Ronald Li: enrolled 2026-10-02, no activity yet |
| Proposed | — | ||
| ACT-021045 | New member onboarding Next-best-action | Helen Cox: enrolled 2026-09-10, no activity yet |
| Proposed | — | ||
| ACT-021046 | New member onboarding Next-best-action | Mateo Aguilar: enrolled 2026-10-12, no activity yet |
| Proposed | — | ||
| ACT-021047 | New member onboarding Next-best-action | Alexander Ortega: enrolled 2026-10-04, no activity yet |
| Proposed | — | ||
| ACT-021048 | New member onboarding Next-best-action | Bruce Knight: enrolled 2026-10-15, no activity yet |
| Proposed | — | ||
| ACT-021049 | New member onboarding Next-best-action | Steve Weaver: enrolled 2026-09-23, no activity yet |
| Proposed | — | ||
| ACT-021050 | New member onboarding Next-best-action | Dorothy Kennedy: enrolled 2026-09-23, no activity yet |
| Proposed | — | ||
| ACT-021051 | New member onboarding Next-best-action | Diana Obrien: enrolled 2026-10-05, no activity yet |
| Proposed | — | ||
| ACT-021052 | New member onboarding Next-best-action | Jsaon Hoffman: enrolled 2026-09-22, no activity yet |
| Proposed | — | ||
| ACT-021053 | New member onboarding Next-best-action | Janet Adams: enrolled 2026-09-23, no activity yet |
| Proposed | — | ||
| ACT-021054 | New member onboarding Next-best-action | Pamela Mills: enrolled 2026-10-04, no activity yet |
| Proposed | — | ||
| ACT-021055 | New member onboarding Next-best-action | Ray Guerrero: enrolled 2026-09-16, no activity yet |
| Proposed | — | ||
| ACT-021056 | New member onboarding Next-best-action | Yuki Cox: enrolled 2026-09-15, no activity yet |
| Proposed | — | ||
| ACT-021057 | New member onboarding Next-best-action | Deborah Pyane: enrolled 2026-09-16, no activity yet |
| Proposed | — | ||
| ACT-021058 | New member onboarding Next-best-action | Austin Duncan: enrolled 2026-09-07, no activity yet |
| Proposed | — | ||
| ACT-021059 | New member onboarding Next-best-action | Susan Stewat: enrolled 2026-09-27, no activity yet |
| Proposed | — | ||
| ACT-021060 | New member onboarding Next-best-action | Alan Hansen: enrolled 2026-09-20, no activity yet |
| Proposed | — | ||
| ACT-021061 | New member onboarding Next-best-action | Juan Taylor: enrolled 2026-10-14, no activity yet |
| Proposed | — | ||
| ACT-021062 | New member onboarding Next-best-action | Judy West: enrolled 2026-09-11, no activity yet |
| Proposed | — | ||
| ACT-021063 | New member onboarding Next-best-action | Linda Stewart: enrolled 2026-10-15, no activity yet |
| Proposed | — | ||
| ACT-021064 | New member onboarding Next-best-action | Jesse Crawford: enrolled 2026-09-16, no activity yet |
| Proposed | — | ||
| ACT-021065 | New member onboarding Next-best-action | Thomas Young: enrolled 2026-09-20, no activity yet |
| Proposed | — | ||
| ACT-021066 | New member onboarding Next-best-action | Adam Guerrero: enrolled 2026-10-08, no activity yet |
| Proposed | — | ||
| ACT-021067 | New member onboarding Next-best-action | Richard Berry: enrolled 2026-09-25, no activity yet |
| Proposed | — | ||
| ACT-021068 | New member onboarding Next-best-action | Amed Garcia: enrolled 2026-09-13, no activity yet |
| Proposed | — | ||
| ACT-021069 | New member onboarding Next-best-action | Logan Marquez: enrolled 2026-10-16, no activity yet |
| Proposed | — | ||
| ACT-021070 | New member onboarding Next-best-action | Nicole Watson: enrolled 2026-10-04, no activity yet |
| Proposed | — | ||
| ACT-021071 | New member onboarding Next-best-action | Elijah Chavez: enrolled 2026-10-12, no activity yet |
| Proposed | — | ||
| ACT-021072 | New member onboarding Next-best-action | Carl Carpenter: enrolled 2026-09-07, no activity yet |
| Proposed | — | ||
| ACT-021073 | New member onboarding Next-best-action | Hill Mary: enrolled 2026-10-09, no activity yet |
| Proposed | — | ||
| ACT-021074 | New member onboarding Next-best-action | Donna Powell: enrolled 2026-09-16, no activity yet |
| Proposed | — | ||
| ACT-021075 | New member onboarding Next-best-action | Simpson Aisha: enrolled 2026-10-11, no activity yet |
| Proposed | — | ||
| ACT-021076 | New member onboarding Next-best-action | Elizabeth Foster: enrolled 2026-10-18, no activity yet |
| Proposed | — | ||
| ACT-021077 | New member onboarding Next-best-action | Mracus Olson: enrolled 2026-10-18, no activity yet |
| Proposed | — | ||
| ACT-021078 | New member onboarding Next-best-action | Alice Carter: enrolled 2026-09-05, no activity yet |
| Proposed | — | ||
| ACT-021079 | New member onboarding Next-best-action | Joyce Rios: enrolled 2026-09-16, no activity yet |
| Proposed | — | ||
| ACT-021080 | New member onboarding Next-best-action | Santiago Oliver: enrolled 2026-09-10, no activity yet |
| Proposed | — | ||
| ACT-021081 | New member onboarding Next-best-action | Valentina Owens: enrolled 2026-10-17, no activity yet |
| Proposed | — | ||
| ACT-021082 | New member onboarding Next-best-action | Brittany Patterson: enrolled 2026-09-06, no activity yet |
| Proposed | — | ||
| ACT-021083 | New member onboarding Next-best-action | Jessica Andrews: enrolled 2026-10-17, no activity yet |
| Proposed | — | ||
| ACT-021084 | New member onboarding Next-best-action | Raymond Contreras: enrolled 2026-10-08, no activity yet |
| Proposed | — | ||
| ACT-021085 | New member onboarding Next-best-action | Vicky Fields: enrolled 2026-10-18, no activity yet |
| Proposed | — | ||
| ACT-021086 | New member onboarding Next-best-action | Diane Carter: enrolled 2026-09-22, no activity yet |
| Proposed | — | ||
| ACT-021087 | New member onboarding Next-best-action | Omar Wheeler: enrolled 2026-09-10, no activity yet |
| Proposed | — | ||
| ACT-021088 | New member onboarding Next-best-action | Jacqueline Hayes: enrolled 2026-10-02, 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.