Julianne Fried

As a Health IT Program Director at APV, Julie provides oversite of the contracts that serve the Centers for Medicare & Medicaid Services (CMS) and is the Program Manager for a contract in the Centers for Medicare. Julie is proactive, organized, and high-energy with a proven ability to identify and pursue new opportunities. She has consistently achieved strong staff performance using an empowering leadership style.

Julie is a seasoned leader with over 25 years of executive-level experience in the healthcare industry in a variety of roles, including 12 years supporting CMS as a prime contractor with a focus on the Medicare Advantage (Part C) and Prescription Drug Plans (Part D) industries. Julie supported the Centers for Program Integrity and their goal to reduce fraud, waste, and abuse (FWA) by developing the FWA Effectiveness Audit project plan, contract sampling for pilot participation, audit guide, audit protocol, and validation checklist. This pilot enabled CMS to introduce FWA effectiveness audits and to add these audits to their annual oversight of plans. Julie also developed an automated process to notify Sponsoring Organizations of improper payments made in the Medicare Part D program and collected over $200 million in improper payments. Julie currently is a Program Director and assists the Medicare Plan Payment Group (MPPG) as a subject matter expert in risk adjustment and encounter data for the Part C and Part D industries, by creating training and providing technical assistance. She produced a comprehensive computer-based training on Risk Adjustment Methodology. This is an ongoing series of CBTs which provides an overview of risk adjustment, introduces the risk score formula, applies the risk score formula to specific beneficiary scenarios for payment year 2022, and annually updates for subsequent payment years changes to risk adjustment.

Julie has a Bachelor of Science in Mathematics from Santa Clara University and a Master of Science in Actuarial Science from the University of Nebraska. Julie is a Project Management Professional (PMP)-certified, a Fellow of the Society of Actuaries, and a Member of the American Academy of Actuaries.