Ilya Polyakov Email & Phone Number

Burbank Ca.

Monterey Park, Ca

Managed a diverse, multi-skilled team of Project Managers. The PMO departmentsuccessfully managed implementation of a number of short and long-termprojects:o Paperless office which resulted in 75 percent reduction in paper usage aswell as substantial costs and labor savings throughout the organization.o Designed and built business rules for K2 - Automated Workflow software.This resulted in substantial time savings, efficiency and full traceabilityfor Accounts Payable and Mail Room claims in-take processes.o Enterprise applications EZ-CAP/EZ-EDI/EZ-NET upgrade broughtSynerMed’s key applications up to the latest version which providedupdated functionality, bug fixes and improved performance.o Implemented LiquidPlanner software which helped the Management teamand Project Managers to organize, prioritize, track and document thework. The tool provided better project visibility and reduced risk factors.Mentored team members and created departmental policies and procedures.Developed individual as well as departmental short and long-term goals.

Greater Los Angeles Area

Created and managed Reporting and Data Quality department. Assembled ahighly skilled team of senior level programmers, report writers and data &business analysts. Based on the work of this team LA Care Health Plan achievedsignificant quality improvements, increases in revenue and reductions in operatingexpenses.Produced key and timely data analytics for Claims, Provider NetworkOrganization, Regulations & Compliance, System Configuration, UtilizationManagement and Member Services departments. This information resulted insubstantial improvements in services availability and delivery, utilization andquality, payment timeliness and accuracy, fraud identification and prevention andcost analysis. This collaboration resulted in significant savings, more streamlinedcost-effective operations, reduction in overpayments & interest payments andhigher compliance scores.Created customized decision-making tools, data modeling, data warehouse, globalmetrics, data validation and analytics of all core Healthcare related reporting suchas Compliance, Medicare/Medi-Cal Audits, HEDIS, P4P, KPI, Provider ScoreCards. Created and managed dashboards for the use by LACare Executive team.As a result, LACare Health Plan’s Medicare star rating improved dramatically.Mentored, educated and supported team members in the areas of Healthcare DataAnalytics, Process Improvement, KPI (Key Performance Indicators), RegulatoryCompliance, Operational and Production reporting.Successfully managed departmental budgets, provided direct oversight of day-todayoperations, conducted performance evaluations and guided team memberstraining, professional growth and development. This resulted in high (90+%) staffretention numbers and greater employee satisfaction.

Greater Los Angeles Area

Successfully managed Encounters extraction, submission, processing and delivery process between over one hundred IPA and MSO clients and participating Health Plans, Medicare and Medi-Cal. Facilitated effective business relationships between the Encounter submitters and Payers resulting in increased client satisfaction scores and higher revenues for both DDD and it’s client base.Responsible for data integrity and compliance (ANSI, NSF and Custom formats) of medical Encounters and Claims. Managed the Accountability initiative by creating, maintaining and distributing custom monthly/quarterly production and analytical reports. As a result, company’s clients where able to identify potential problem areas and address them in a timely matter.Enhanced existing products and services as well as developed new custom applications and business solutions to meet evolving customer needs. Managed the development, implementation and support of data integration and compatibility between various internal Claims and Encounters administration systems and data formats (x12, HL7, EZ-CAP, Print Image) as well as related third party applications.Developed, implemented and managed all technical and data exchange aspects (Claims, Encounters, Lab, Rx and Eligibility) of drug adherence study conducted by a major pharmaceutical company with participation of the key California IPA’s. The study focused on at-risk Diabetic and LDL/HDL patients and resulted in a number of treatment protocols that were developed and modified. Responsible for creation and maintenance of Operational, Statistical and Financial reports utilizing MS SQL Server/T-SQL and Crystal Reports.

Greater Los Angeles Area

Launched and managed the EZ-CAP Professional Services Department. Thedepartment was formed to provide custom system implementations, developunique and innovative solutions to solving customer’s problems, conductcustomized end-user training, build benefit tables, capitation tables, fee schedulesand create complex Health Care Analytics tools. Department successfullyprovided project management, consulting and professional services to over 200EZ-CAP clients. The annual revenues increased by more than 30 percent for fiveconsecutive years.Built the EZ-CAP standard report library and customized executive reportingtools/Dashboards for trend and performance analysis.Successfully managed the development, certification and delivery of all EZ-CAPtechnical and end-user documentation such as User Manuals, Data Dictionary,Release Documentation and Training Materials.Consistently exceeded personal and departmental goals, increased revenues andsuccessfully managed departmental budgets.

Computer Science.

Business Management Program.