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
New member onboarding, Next-best-action, 2,081 proposed
| Action | Type | Title | Detail | Linked to | Status | Executed | |
|---|---|---|---|---|---|---|---|
| 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 | — | ||
| ACT-020371 | New member onboarding Next-best-action | Thomas Lee: enrolled 2026-10-18, no activity yet |
| Proposed | — | ||
| ACT-020372 | New member onboarding Next-best-action | Jeffrey Welch: enrolled 2026-09-16, no activity yet |
| Proposed | — | ||
| ACT-020373 | New member onboarding Next-best-action | Gregory Lane: enrolled 2026-09-07, no activity yet |
| Proposed | — | ||
| ACT-020374 | New member onboarding Next-best-action | Angela Herrera: enrolled 2026-10-07, no activity yet |
| Proposed | — | ||
| ACT-020375 | New member onboarding Next-best-action | Teresa Martin: enrolled 2026-10-07, no activity yet |
| Proposed | — | ||
| ACT-020376 | New member onboarding Next-best-action | Juan Park: enrolled 2026-10-01, no activity yet |
| Proposed | — | ||
| ACT-020377 | New member onboarding Next-best-action | Doris Perry: enrolled 2026-09-26, no activity yet |
| Proposed | — | ||
| ACT-020378 | New member onboarding Next-best-action | David Ryan: enrolled 2026-09-22, no activity yet |
| Proposed | — | ||
| ACT-020379 | New member onboarding Next-best-action | Michelle Turner: enrolled 2026-10-09, no activity yet |
| Proposed | — | ||
| ACT-020380 | New member onboarding Next-best-action | Sofia Bowman: enrolled 2026-10-12, no activity yet |
| Proposed | — | ||
| ACT-020381 | New member onboarding Next-best-action | Wei Rios: enrolled 2026-09-05, no activity yet |
| Proposed | — | ||
| ACT-020382 | New member onboarding Next-best-action | Jeremy Kennedy: enrolled 2026-10-01, no activity yet |
| Proposed | — | ||
| ACT-020383 | New member onboarding Next-best-action | Jacob Wagner: enrolled 2026-10-07, no activity yet |
| Proposed | — | ||
| ACT-020384 | New member onboarding Next-best-action | Tyler Clark: enrolled 2026-10-15, no activity yet |
| Proposed | — | ||
| ACT-020385 | New member onboarding Next-best-action | Stephanie Turner: enrolled 2026-09-09, 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.