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-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.