Ladyboss 1:1 - Kat McDavitt and Miriam Paramore

Kat McDavitt & Miriam Paramore Transcription

Kat McDavitt: I am Kat McDavitt and I am interviewing lady bosses for the HIT Like a Girl podcast. And we have our first guest, Miriam Paramore, who is my personal hero and someone who has supported me throughout my career. She is the President and Chief Strategy Officer at Optimize RX and Miriam. I'm going to let you give yourself your intro because it's going to be better than anything I do.

Miriam Paramore: Okay. Hey Kat, thank you so much. Hi guys, and I love HIT Like a Girl. I actually would recommend first out of the gate that everybody take boxing lessons. If you haven't, it's a great workout and it's a lot of fun, very empowering that I've always, I've really appreciated. I want to give a shout just a little bit to him, which has been just a great.

A place for me to be in, be part of, we'll probably talk about that. But anyway, thanks to both of those groups for helping put this together and get the word out.   I was thinking about my  story and how did I get to where I am? I'll start with my day job.

So Optimize RX is a health IT company, and we are publicly traded on NASDAQ and we sit as a connector or a conduit between various people in the healthcare ecosystem. The focus of the company is affordability, access, and adherence to prescription medication. So it's something that is close to my heart.

And there's a lot of talk about health equity. We might get into some of that, but it really inspired me to take this position in terms of understanding how to use data, to help people save money, and then use my sort of techie geek background from the world of HIMSS and so forth to come into this role.

And as President here, I've been here for about four years and Chief Strategy Officer as well, and we've had a really good market reception to what we do, which is making sure that doctors know what the prices of prescriptions and what the availability of copay coupons and other savings opportunities are, and that patients can get access to those drugs easily.

And. You know, that's kind of our role. My career has been about 35 years and I started out like in the way back before computers. So we can kind of get talking way, way back the way back in the way that I call them, you know, pre -COVID the before times, like, when I used to shower every day,

Kat McDavitt: Just so everyone knows we did shower for this specifically though.

Miriam Paramore: I did, I blew out my hair, put on some makeup and you know, so this is a fancy day today. Yeah, pretty sure. I have had an interesting observation through the course of my career cause I did, I started out as a programmer. My degree is in math and computer science and I was listening to somebody last week talk at the Women Business Leaders conference, which shout out to Lynn Shapiro Snyder, who runs Women Business Leaders in Health care, another great organization to learn from and be part of. A couple of the folks were just saying, you know, we're kind of, where did they come from? And I grew up in the Southeast. I grew up in Tennessee and North Carolina and my dad was a preacher.

So right there, everybody that's listening to, this is going, ah that's, what's wrong with her. Raised in a super, a super small kind of an environment and bubble. And I went to Belmont University here in Nashville, a small liberal arts college. So, nothing really fancy about that. I have an undergraduate degree in math and computer science and got out of school and went to work for HCA as a programmer.

And, you know, from there I did a lot of different things. One of the things I think is interesting is sometimes many of us don't feel that great about where we went to school or maybe we don't have an Ivy league or,  maybe we didn't come from Silicon Valley or,  wherever some of the  bigger places and that's okay.

You can still rise up. Yeah.

Kat McDavitt: Well, I wanna, I know that's that's something that I've always thought was a great learning from you. And I want to get there but I know you also have this incredible career trajectory, right? Like you've done amazing things. So, let's come back to that, but yet so you were a programmer at HCA and then suddenly you became President of Optimize RX. Is that how it happened?

Miriam Paramore: Yeah, that helps It's how it happened I was in a coma for 34 years and then I woke up.

I think of my career in kind of three sections. I think of it as I just needed a job right out of college and that one was available. And early in my career, I learned that I like technology and I'm good at it.

I really like technology. I like data. But what I like more than that is using technology to improve things in the healthcare system, the delivery of healthcare, or to solve sort of business problems. And I, as I got into a little bit further in my career, I got into management consulting at ENY. And from there, I kind of got a bird's-eye view of multiple parts of the industry.

And that was when I got really my first big break. One of my clients gave me an opportunity to come in to be general manager of a revenue cycle company. And I took that job. And from there, I became the CEO of an Anthem subsidiary. I was really young. I was like 30, 31 years old. But it was a big responsibility at that time.

It was a wholly owned subsidiary doing all of the revenue cycle transactions all the EDI, all the claims remittances, eligibility, all the kind of HIMSS-esque kinda commerce of healthcare and gave me an understanding. This was in the early nineties of the revolution, really revolution transformation from paper-based claiming to electronic claims and electronic eligibility verification and electronic payment.

And from there, I grew that was kind of a big step up from leading you're leading your business.  Yeah. I was running this little small business in relative terms, but it was part of a very huge company. And that's how I got to Louisville, Kentucky from Indianapolis, where the headquarters of Anthem was at the time where it worked.

It was interesting, and I met one of my first mentors Shields Switzer, who was just leaving that job to go and do some other things. And she's been a mentor and stayed with me, you know, she's a serial entrepreneur, very successful in health IT and she gave me lots of good advice as she was leaving and going on to her next thing.

And then from there I had my first sort of personal kind of crisis where I I had a lot of changes in my personal life. I got divorced. I had two small sons and I really had a, you know, existential crisis. I'm not sure I can manage all these things that are going on in my life right now.

And I took a really big risk and I left that, you know, Sort of prestigious job in a big company. And I just left and I didn't have it net to jump to. But what I did know was that I needed to get myself together and focus in on the balance of my personal professional life and being a single mom, which was sort of really different from where I thought I'd be when I made that move to Louisville and I needed to marshal my resources in a different way than maybe I had done before is a big life change. I had just moved to a new city, got divorced six months later, you know, just a lot of change. And so that, that change taught me that when you have skills and knowledge and a good network, which are some of the other things that we'll talk about today, you know, you really can drive your own destiny, and you can make decisions that somebody else would say, well, you're insane too. You know, nobody does that. Nobody walks away from that or nobody goes and does this. I didn't do it because I was brought all that smart, but I did it because I knew I needed to and it's knowledge that I needed to make a change.

I also had this knowledge that I had this knowing that I had knowledge and I could make a path for myself and specialty knowledge and a strong network of relationships. I had built up over the prior probably 10 years or so. And I think it's a little bit similar Kat in a way too, when you started in Ciena you know, you were with an extremely well-known agency and very well known within that.

But I remember that time maybe for you.

Kat McDavitt: Yeah. Well, that's, I think this is something I'd love to actually talk about a little bit, because I think these big moves, I know a lot of women can struggle with them. Not only is it like, you know, the classic imposter syndrome, can I do it on my own? Like, is this going to be okay? But I think that and I've spoken about this too, and you helped me through that period of time, even just by being there on the phone with me when I was like, just talking at you. But I think what I've learned from that period is exactly what you're saying.

If you have the skills and you have the network and you have delivered results, I think you can do anything.

Miriam Paramore: I agree.

Kat McDavitt: And I think that what I learned people like that at that time of my life, not a very interesting person. Never really thinking other people were going to pick me up. I fell backward. I did the trust fall and everybody was there for me. And I think, yeah, I think that was awesome.

Miriam Paramore: Yeah. You know, when everybody that hasn't worked with Kat, she's one of the best in the industry, if not the best she is the best PR.

Kat McDavitt: I paid her for all of this.

So, I, and all these other businesses that I did after I left.

But, you know, I just tell you that I'll kind of fast forward. So that was kind of the middle section of my career and come back to that. And then the last section of my career has been, you know, so I went, I had my own consulting firm for about seven years. I focused on HIPAA and, you know, technology sort of transformation around the ledge Ridge.

And one of my really good friends, George Lazenby, who I had met through HIMSS and done volunteer work with for years around data interoperability, standardization, data transparency the power of data, which is where my passion is. He became the CEO of Emdeon, which has now changed healthcare. And. I was fortunate enough to be his first executive team hire.

And I, I didn't think I'd go back into a big business at that point. It's kind of having fun and, you know, doing my own thing and very loosely defined in terms of nobody else's agenda, but mine. But I had such a, he gave me such an extraordinary opportunity to come in and run strategy with him and we had an incredible run.

We took the business from about 600 million to 1.2 billion. We took it public was the largest health I T IPO at the time. And in, in running strategy for that group and looking across all sectors, I got even more exposure into health plans and how they were hospital systems, practices, retail, pharmacy, you know, PBM the backend And really what does it take?

What's the data plumbing that kind of goes under all of that? And then you don't just have data for the sake of data. You hope that you can transform it into information and make it useful and improve our healthcare system. I left Emdeon after we sold it, we took back private and sold it. And then in the last very, you know, kind of seven years of my career, I'd worked a lot with venture and private equity companies.

We did a lot of acquisitions, but I'd not been an angel investor. So, I'd never written my own checks with my own money to put into somebody else's business idea. So, I got, I helped start a group here in Nashville called Nuclear Partners. I was one of the first members there and it's a bunch of individual people like me who have, who are former operators or operators of businesses.

Not people that come from a traditional investment banking background or went to business school. And we started this angel investment group. So, I've done, I think, five investments now. And one of the companies is out of business, right? And I still, you know, I have the pleasure of doing this day job and that I got, I met Lynn Boss who is on our board of directors who ran one of the largest agencies in the world focused on life sciences. And I just met her at a WBL standing in the hall, you know, and that's one of those things. That's a great value of network and you don't underestimate it because you never know who the person you're standing next to is. And she was like, Oh, this is what I do. And I said, well, this is what I do. And she said, you know, that sounds a lot like this coming down in the morning, you should meet the new CEO.

We're going to build a management team. And so, I did, and I from there, I really loved the idea of really helping data to surface all of these affordability options for patients to help them afford their medications and get access to them quickly. And you know, that's this part of my career.

And as I move forward, maybe in the fourth chapter in my career, it's really about finding leverage for myself. So, one way to, one way to do that is serve on boards. And I do have one health IT board that I'm on private equity backed company. And this is where, you know, I'm quite a bit older than you.

So, it's been 35 years for me in healthcare. And you just, you learn a lot. And you know, you know, a number of things and then you can help other companies that are at different stages and you can help people that are trying to start something, things like you're doing with the fund that you've just started.

You can make choices. You have you have what I call optionality. Whereas earlier in your career, you just try and earn a living.

Kat McDavitt: Yeah no. I agree with that. And I love where you're going. I love some of the ideas you have for your phase four. I think it's awesome. And I want to go back to talking about the power of a network.

Cause sometimes, you know, you hear these podcasts or whatever, and you're like, ah, networking, blah, blah, blah. And it seems so academic. But in, in my career, and I know when yours based on what you're saying and what you've shared with me I would be nowhere without a network and it sounds a little bit contrived to stay, but yeah, those hallway conversations, you know, drinking a glass of wine at the bar, you know, just meeting people in an airport.

I think that those kind of run-ins, those more casual run-ins have like honestly altered the direction of my career. Yeah.

Miriam Paramore: And I agree. And I would say that, you know, for one of the biggest Sort of strengtheners of my entire career has been HIMSS. HIMSS is a fantastic organization. It's just like anything else in life.

And it does sound cliche. You get out what you put in. And you know, it, many times I would have my staff. I would, as I built teams in different companies, I would say, you know, part of your job is to volunteer some of your time. To work on something at HIMSS. And you know, you don't go in there saying, you know, I'm going to be the star of this new show.

I want to be the chair of this committee. You go in and you just raise your hand and you say how can I help? You know? And if you're the person that needs to be, you know, set up the chairs for the meeting, that's kind of where you start. And I, that is where I started. And you do work and from there you make connections with those committee members.

You, you know, you really have to intentionally work this network. So, it's, you know, there is random stuff and sometimes random stuff leads. It serendipitously leads to something, but more often it's really tending to relationships. As if you really want that relationship to know that person, to know you value.

Knowing them without ask.

Kat McDavitt: Yeah. And you just said something that I think is really important and it's, how do I work this network? It's almost, how do I work for this network?

And, yeah, we've talked about this in the past too. And I feel like it with me, I feel like the more that I put in, the more that I give, the more that I have.

And it's definitely not why you don't go, Hey, I'm going to go, you know, volunteer and I'm going to put all this in because I expect to get an amazing amount of stuff out when you really have to care about people. Otherwise, it's not authentic.

Miriam Paramore: That's right, it's not authentic. And that, you know, I do think though that sometimes just working, you know, if you really work to show up, if you show up people respect that's a lot.

That's a lot of it. And then no one has the capacity of the time, the energy to network with everybody. So, you have to, yeah pick people. But you find energy to, you know, widen that circle. And HIMSS has been a great organization, women business leaders, which I mentioned using LinkedIn strategically.

And don't ask for more than you give, give more and then you're going to get back, you know, and, but you don't know exactly how. You know, it's going to show up. Yep. But it will. And just give it to people. And, you know, it's important and you can follow them. You can care about them, you can help them.

And it definitely comes back for sure.

Kat McDavitt: I completely agree with you. And so we're talking about networks are talking about putting in the work and being, you know, just doing the job and getting things done, even if it's not for your actual day job. And I want to go back to the discussion on education.

Because this is something that I gained a lot of confidence in my own career from hearing you talk about this and, you know, I have like kind of worthless Bachelor of Arts degrees, like in religion and politics, like what and I've made it quite far in a technical field.

And you always talk about, you talk about those little. The degree you have from Belmont U, that's actually a very good school. I'm not sure you checked in my way a long time ago. Maybe it wasn't that good back then. I don't know.

Miriam Paramore: No, I don't have an advanced degree. I didn't go to Harvard, you know?

Kat McDavitt: And you have really good advice. I think that I'd love for people to hear about being in that position and what the doors aren't closed to you necessarily, you just have a different path.

Miriam Paramore: That's true. I'll say that I, you know, for a long time, I really have a little bit of a pity party for myself because I didn't go to school. And I do think it's a little bit it's probably a little bit harder. And the reason is that when you do go to a renowned name school, they have a lot of built in networks, you know, you'll see a lot of people do business together. Well, we went, we were in business school together. Well, I learned, I didn't even know what that meant business school.

I thought, well, what does that you know, here's Harvard or Stanford

Kat McDavitt: B school. They go to the beach. I went to one of those. Cool. Are we talking about a tier B school? Cause I went to one, right?

Miriam Paramore: Exactly. I didn't. You don't, I didn't know. I didn't know what it meant. But there is Def, so that's part of the value of that education that people pay for.

You do come out of that you have that camaraderie everybody's gonna rise up. And you know, you know, kind of, you know, each other, you can create the same thing for yourself, regardless of wherever you get your education. Or even if you don't have an education. There are a lot of people that don't have, you know, a college degree that have done amazing, you know, world changing things.

Where it, I let it be in my own head. I let it be a limiter to me for a while. And then I got to the place where I was like very defiant. And I was like, you know what, in spite of the fact that I didn't have a an Ivy league education. But now I look at it just a little bit more philosophically and I D I want to encourage everyone that regardless of what your formal education is, lean hard towards lifelong learning. I used to hear that and would think, Oh, that sounds, I don't know what that is, but I don't want to do it. Lifelong learning, but then I found out that I actually do it anyway. And one of the things, ways that I do it is I'm very intellectually curious.

So, something that I'm learning about recently just through my network is genomic medicine. How genomic medicine, genomics are coming into healthcare service delivery, the field of pharmacogenetics, which is the, you know, your section of our genome with a specific pharmaceutical, super fascinating new frontier, next frontier of how medicine will be practiced.

And so, I'm curious about that. And I read about that and I learned about it. It doesn't really do anything in my day job. But it's fascinating. And then the other thing that I'm really done is work on my business skills and some of my mentors helped me with this. Like they would say, I, listen, you're not an accountant.

But if you're going to run a company, you need to understand financial statements and you need to be able to understand what the numbers mean and what's behind the numbers. And you really can run a business backwards from a spreadsheet if you know, what the numbers mean, because the results always show up in the numbers.

And then you can trace back to, you know, what's driving these. So, I had to, you know, seek that sort of. MBA ish, financial ish sort of knowledge differently. But I needed that knowledge and nobody just gives it to you. You know, that was an OJT. And then these there just lots of educational opportunities and just, you know, don't allow yourself to think you're never, we're all never done learning.

But you can round out your own sort of what I have learned round out your base education with some of the other things that you may need to run a business or to have deep subject matter expertise. You know, in your case you're one of the most content rich people I know in terms of the health IT and health tech, that industry, you know, that industry cold, but you don't have a degree in that industry?

Kat McDavitt: I sure do not,

Miriam Paramore: but you have applied your skills and just continue to learn. So, I do think that's that's been a big help for me. Yeah. Yeah, the on, on the job and then this we'll call it lifelong learning because you know, like it might make us squint a little bit.

But yeah, no, I agree. I think as long as you can, as long as you put in the work, again, as long as you have a little bit of grit and you're curious, right. I think that you can go really far.

Kat McDavitt: Okay. So, this could turn into my love letter to Miriam Paramore. So, I'm gonna try, I'm gonna try not to do that, but I would like to talk about your super powers.

And you know, this is like another one of these contrived things you hear on like a women's empowerment podcast or something, but there's some truth to it. And I think there's truth to knowing what you're good at and leaning into it. So tell me in your him so that I don't have to turn this into the cat. McDevitt loves Miriam show. What are your superpowers?

Miriam Paramore: Well, you know, it always makes me a little uncomfortable, but I I'll, let me try to answer that sincerely. I think that my superpower is strategic thinking. I seem to have the ability to look at a very complicated set of facts or a very complicated set of industry movers or markets or activities and connect all the dots very quickly and in a way that other people may not.

And I think that skill combined with my very deep knowledge of healthcare and healthcare tech allows me to be of service to people that are trying to invest in companies, people that are trying to build companies or take a product and turn it into a business. And that's probably the thing that I'm the best at.

And on the flip side of that, I was listening to the, some people talk about their superpowers last week. Cause it is kind of a thing people do I ask well, why don't we ever ask what's your kryptonite, we always just look, we'll get to that. That's one of my favorite topics, but to me they're connected and I know they're connected for me personally.

So, part of my superpower and part of what's gotten me to where to where I am is I have a pretty good clock speed on that mental clock speed that goes along with what I was just saying. So, I can see the end and see the conclusion pretty quickly. And then I put on top of that, some pretty rapid fire, pretty transparent slash blunt.

Kat McDavitt: I love your direct style.

Miriam Paramore: So very direct. Thank you. And you know, I. I think that's okay. I have taken a fair amount of criticism through the years. I do think there's some gender stuff going on with that, but a lot of that criticism is constructive and fair and there becomes my kryptonite.

You know, I would say that my my favorite saying, I say this often is that weaknesses are strengths overplayed. You know, just as an example, if you're confident, that's a strength. But if you overplay it, you can become arrogant. That's a weakness. You know, so for me when I go too fast, when I'm frustrated or tired, when I'm emotional, rather than, you know, dispassionate my direct and blunt communication, it's just not It's just less appropriate than it could be, you know, and piss people off.

It can turn them off. But what I've learned is that it's also great because it just cuts through everything and it can save a lot of time. And it's something that I appreciate about you that I would never, I don't want to be surrounded by people who take a long time to say something, you know, I was always like, get to the point, so nice way to say it.

And I don't want to be surrounded by yes people. And if someone, if you know the answer is no, tell me no. And I'm going to get grateful that you told me quickly. So, I left to get to a fast, no, where rather than a drawn out, maybe. You know? Yeah, well, it's taken me a long time and I still struggle with it a little bit, but it's taken me a long time to just say, look, that's who I am.

That's how I communicate. And if it comes, you know, as I try to harness that a little bit Kat, and kind of smooth that out I'm sometimes I'm better than others and sometimes I'm just not, I'm just not that good at it. And I have to say, Hey guys, mea culpa, you know, I can't be a different person than I am.

And so, I have to embrace that, but I also have to adjust, you know, for the audience. I think we talked about this a little bit last time, that it's really important to think about who your audience is in all of your communication. And sometimes I just forget, you know?

Kat McDavitt: Yeah. Well, we'll need to be too. I think you and I have a similar, a superpower slash kryptonite.

And I've learned that more about myself now that, you know, I just came off this journey of being actually employed as an executive at a company that exited very well recently. And it was different, when you're a consultant, like you're kind of paid to be in charge. Everyone expects you to be in charge.

Miriam Paramore: Yeah. That's true.

Kat McDavitt: That's true. You don't have to blend in with them. You don't have to blend in and you're allowed to be shiny and weird. And and you can wear your weird earrings and whatever. And I think in a setting where you're part of a true team and we have teams and agency, but like pool the different right.

But when you're part of a real executive team you know, and I'd have an idea and I, you know, I'd be like, this is what we're going to do.

And, you know, and I would just say it and even if it was counter to everyone else, I would just say it and I'd be like, I'm right. Like, why aren't they just doing what I'm telling them to do? Cause I was so used to just being like, here's what's happening.

Miriam Paramore: But you hired me.

Kat McDavitt: I would say it like, I didn't actually ever learn how to do it that well, but I was trying a little bit, maybe no one could notice. I was trying to be like, here's my idea. Do you think that's wrong?

Miriam Paramore: Exactly. And you know, I love that about you. I. I love that about I love that about you. It's the, almost the efficiency aspect of communication. If you want to get the job and it kind of goes back to the clock speed. Sometimes it can be counterproductive. I do want to take just a minute if it's okay.

This will kind of carry us to the The education, the things that you, I, you learn. And I have seen with this HIT Like a Girl kind of thing in, in mind, I've seen that women leaders. Generally, are more direct than a male leader. That's my experience in their communication style.

And the thing that kind of makes me angry still is that I know this has been assigned to me well, you're intimidating, you know, you're intimidating and it's that you know, strong male leader, you know, strong men are leaders, strong women are. But it put a nasty, whatever,

Kat McDavitt: leave it out, whatever. We'll leave that up.

Miriam Paramore: And yes, that's frustrating because the in the early part of my career, I'd say probably the first half of my career, Kat, I did not see myself walking into a meeting as a woman. I saw myself walking into a meeting as a coworker. That's really true in my mind. I wasn't thinking of myself as a female human.

I was thinking of myself as a colleague.

What other people were seeing was that's a woman and maybe an aunt she's a colleague, you know, they might right. Fine. But they were and I wasn't aware enough that at that point that there was a lot of gender sort of differences around how people think of strong women.

And so, I do think that's, you know, intimidating is code for, you know, you're too strong or too opinionated or too something. Whereas with male counterparts I've seen that not be the case as much. And so, I think I raised that not to have let's all feel bad about that, but if you're aware that other people may not be as thoughtful as you are about, you know, there's a lens and like really hurt.

Like really hurt by seeing them because I thought, wait, does it, you know, I thought that we were all in the room. Well, we're all the same in the locker room, kicking stuff around and , you know, hear  these are ideas and but that, wasn't the case a lot at the time. And now I'm a little bit better at sensing it.

And one of the great things about getting older is sometimes I don't care at all. I just go like, okay, call me whatever you want to call me. Put in the adjective, put in the descriptor, you know, I don't care.

Kat McDavitt: I'm totally with you. I've you know, earlier in my career, I didn't same thing. I didn't really think about it. I didn't. And also I was in a female dominated industry. Right? Public relations agencies are, there's a lot of women.

But at some point the company invested in coaches for some of the executives. And so I got one and this coach, it was actually very... listen, if anyone has a chance to do that, it was really helpful for me because you don't know, other people perceive you.

Oh, yeah. This coach told me, he said, he's like you intimidate men, specifically. Did not say I intimidate. No, I'm pretty sure I intimidate both.

I don't think I've, but especially for clients, you intimidate men and you, you need to develop some sort of disarming device to your personality. And so, I think what happened is I've developed kind of this, like. You know, like just, you know, my style is very, like I'll joke around and I'll tell a bunch of bullshit jokes and then I'll like, go for the juggler.

I'm still not sure it works, but it's but people tell me that I have that all the time and I'm like, Oh, that, that was a decision that I made with someone else to try that.

And I guess I was like a one hit wonder. I never tried any other tools to get around it. And I think back in, I get mad too. I'm like, why did I even have to do that? And, but I. But I think, you know, especially in consulting, you have to pay attention to some of those things and

Miriam Paramore: You do, and, you know, we're all, I just, it brings to mind that, you know, people do business with people that they like. You know, you have to be always conscious of, you know, never trying to do it to be mean, but you could offend somebody.

And I do have been people when I like get too excited and I'm running my mouth and you don't come up with ideas. And, you know, I like to be around. I like to laugh a lot and sometimes people don't think my jokes are funny and, you know, but I, you know, I just think that for all of us that are listening, all of us, they're out there every day.

There's something about who we are that someone else is not going to lie. That's just fine. And it's okay. And if I were not, you know, if I kept trying to edit myself back too much, I would just be   shriveled away to maybe a shadow of myself. And I don't want to, I don't want to do that.

We all should be ourselves. I think that your idea of, you know, a. A sweet, not a sweetener, but a disarm or things like that. Feel out your room. That's some really good advice, you know, feel out your room and try to really understand. Where people are coming from to the degree you can, fortunately, it's not that hard.

And I do want to say that it takes practice, but I didn't know where the room was. And I've talked to you about this, like

Kat McDavitt: Some of my favorite Miriam stories.

Miriam Paramore: Yeah. I used to think, you know, what I wanted to do was I wanted to get into the position of authority and want to have a voice. I want to be a leader.

I want to be a decision maker and they're all for, in some room somewhere, you know? And there's the board, there's the board room. You know, and then there's the executive conference room. I'm like, where are these rims? And how do you get into these rings? You know, who is in there. And most of the time in my career I have, when I found the rim, I was the only girl in there.

And that's my book. I'm gonna write the only girl in the room. Yeah. There really is. This is really true. And all the statistics about women, CEOs, women on boards you could go to any measure and we're making tons of progress there, but there is a built-in 2000-year head start in the patriarchy society that we have minimum 2000 years come out.

When you talk about education, if you're coming out and you're having, you know, 90 to 95% of the folk in that class, are, you know, male you talking about like Ruth Bader Ginsburg, one of my heroes, you know, she was, she got her degree, her, well, her law degree at Harvard, no one would hire her as a lawyer.

And she had it. She was only woman in the class and all of these things that was only 50 years ago. Wasn't that long ago. And and girls in STEM, you know, science, technology, engineering, math we don't have enough female representation. So, the pipeline comes out and if you've got this fraternity sorta thing going, you know, somebody knows where the cigars are and where the rudeness.

And like, they're like, Oh, it's mine. And we went to school together and you know, the school friends, you know, son. So it took me a long time to you just, you have to meander around to find where the room is, and then you have to earn your right to be in there. And that's just about earning and having the merits,  to really kind of be a contributor at that level.

And we can absolutely do that. Does it take a little bit more effort? Yes. But there is, there are people who have a lot of intention around. I even NASDAQ now for publicly traded companies, they're counting female representation on NASDAQ traded companies. These are important, very big breakthroughs that we're making, but you got it. You got to find it. And nobody's going to tell you where it is. 

Kat McDavitt: Yeah, well, exactly. So, we were talking, we were having kind of a casual, like fun conversation a few weeks ago, Miriam, and you said something to me that I love. And you said, you know, Kat women don't have the book.

Miriam Paramore: Yeah, we don't have, we don't have a book.

Kat McDavitt: And I think what's awesome about you and some others who mutual friends of ours is that you guys, you have figured it out, you have found the room, you've got to see at the table. Didn't even know, didn't even know what those seats look like before you got there.

And you have been the only girl in the room. But the great thing about you is you're kind of sharing the book. And it might be chicken scratch on post-it notes, but you're sharing the book.

Yeah.

And I think the more women that get into those positions and do the hard thing. I think the easier it's going to get and again, I think this little TV show we're doing here, I think is evidence of that, right? Like how can we help other people do that?

Miriam Paramore: Yeah. Well, I thank you. And it's one of the joys of my life. You know, I've been working with women empowerment efforts now for about 15 years and I got to set one up inside of Emdeon, and it was an affinity group and just an overwhelming response because that people want to know where the room is and they want it. They want to know, and they want to succeed. And people are coming from all different kinds of backgrounds and education and ethnicities and countries.

And, you know, sometimes just basic language is a barrier. You know, there's multiple things going on here. You know, and I'll never forget. We had our first women of Emdeon meeting and we'd had a little breakfast and there were over 200 people that came there. We just had some breakfast things, 200 women show up and we did this sort of speed dating thing, where we could just talk to people and little clips of times.

There's so many people, this one lady came up to me and she's, we had 4,000 people in the company, so I didn't know her, you know, and she worked in like one of the customer support areas and. She came up to me and English as a second language. So she had a strong accent and she said, I'm just so glad to meet you.

So nice to meet you. Meet these other women. She said, I'm the first person. She said I'm the first woman in my family to go to college. And then she said, I'm the first woman in my family to even have a job. Wow. And I was just like, she was so emotional about it, because for her to have stepped into these realms where her own family had not stepped into these realms and she got the education and she made the choice.

It was just so moving. And so just connecting to other women so that we can just help and energetically raise each other up. It's a great joy. And that's why I love these sorts of venues. You know, we can take a punch, we can deliver a punch, you know, to now, I that's yeah,

Kat McDavitt: that's correct. And I've shared this with you before too, but I've often been told that if someone comes at me with a punch, I block it and then punch back in and trip them a little bit later to show them you know, we all have things to work on whatever

Miriam Paramore: I get it, there's a, you know, there's a good lesson there that it does, it pays it, it really does pay to be strong. We have to be strong. And I think that comes from an inner knowing. So, like kind of know your strengths, but also know your kryptonite and then say kind of that's okay. You know, bleep, but you have to be able to pull this all in and say, I'm okay with this. And

Kat McDavitt: then I'm also as me and

Miriam Paramore: I can take the ups and downs, but I'm going to make it and then, you know, ask for help if you don't know. And then you can just continue to move as you go along, but you have that authentic strength.

Cause it, it is coming from inside you, but we don't have to be defensive. And that's one of the things I'm learning. There's a difference between being strong and having that confidence and being defensive, which to your point earlier has been something that, that has happened to me where I've been defensive because you, you know, you're just one down, you know, you're one down and you're You know, it's kind of like my experience when I talk to people from the Northeast, you know, it's like, well, yeah, I'm just, I'm Southern.

You know, I don't know. So, it's, it's like area, like maybe you go in and most women don't feel this way anymore, but maybe you feel intimidated when you go in, if you're the only girl in there, you know? And so, if you feel that way, then you can put these, sort of like, you know, you can be defensive, like

Kat McDavitt: pulling the razorblades out of your scrunchy. You know, like maybe that's just a joke.

Miriam Paramore: and that energy people can feel that energy, but you do want to be strong, you know? And so those are things that we learn. I think, as we. As we get a little more mature, you said something the other day to me about that y'all wanted to kind of mention about just watching what other women do. Yeah.

Kat McDavitt: Well, well, let me talk about that. Cause this is this might you guys stop me if this turns into a love letter again, but and I've talked about this publicly about, you know, people ask me like, Oh, how'd you get where you got, blah, blah, blah. And one of the greatest gifts of my career honestly, has been not even, I your friendship has been amazing. Let's be clear, but just having the opportunity to watch you.

And so, for everyone I met Miriam when she was in the strategy role at Emdeon, and she was like big deal lady boss. And I was, you know, beginning of my career so to speak. And I saw her in meetings just little things that, that I think I wouldn't have otherwise known how to deal with.

And so, she was spoken over by a colleague male or female only girl in the room. So most likely it was male. But just watching her gracefully say I'm not done speaking and continue on. Was those little things I think are so valuable. For other women to see and see the reaction and say, that's okay.

And I can do that. I can mimic that. It's been phenomenal. And even kind of watching you, you know, move through your career and take on different positions and the choices you've made and the no’s that you have said, that's been important for me to watch what you have said no, to has been more impactful for me than what you've said yes to.

Miriam Paramore: Oh, wow. Thank you. That's really interesting. Thank you for that. And I really appreciate that. It means a lot to me coming from you and I and kind of just really coming from me because I have so much respect for what you do and how you do it. And I'd say also that I want to share that it's great to be a fan of each other and it is very nice, you know, it is. And I, people have talked about a lot, you know, do women support other women or are they tearing each other down or fighting? I've really never found that to be true. I have not found, maybe they were like, and I didn't know they were, but to, to my knowledge, I have not found that to be an issue.

And if I would say, if anyone feels that they need to tear down another woman, I would say, look right inside yourself, girl, because there's something going on in here. The world is big enough for all of us. And even though the, there are a few slots, you know, you're not going to get there by making somebody else less.

You're going to get there by making yourself more, you know, when you can earn your way. To wherever you want to go. But I know I need it. Like these words of encouragement or somebody says, Hey, I saw you do that. And I thought it was really impressive.

Don't underestimate how important it is to tell somebody that they did a really good job, you know, to say that was amazing, you know, Kat, the way you pulled that off. And, you know, we got from this sort of market recognition to this sort of, you know, market recognition and net promoter scores and whatever you want to measure.

Kat McDavitt: I love it. I love what you're saying, because I think that I've recently had this experience where where I've had, it was really flattering, but some women asked me to be their mentors and I was like, Holy shit.

Like even do they even know what's going on in here? And. And what they told me was like, Oh, like, you're so confident and you've done so much. And you really like, you know, you pull people through the battlefield and I'm like, yeah, and it's crazy. Cause I think people don't realize when you're talking to a confident woman, who's, you know, had some great accomplishments, they think, Oh, she doesn't need to hear that.

She, that we'd like to think she did.

But it was so impactful, to hear like, Oh, like you really person. Cause people don't see what's going on inside. They don't see that like maybe you were tough in a conference call or whatever and did a big thing, but then you kind of cried about it and the bathroom.

That's just me. But it really, it's so impactful to hear those things.

Miriam Paramore: It's true. And I hope that, you know, people, as they think about leadership and female leadership, there, there is a place in a time to say, Hey, look, I like, just talk about your feelings. Like you can say, look, I, my feelings were hurt because somebody said this, you know, and words are powerful. And then you feel like you should be above all that, or you should be beyond it or so, you know, whatever, but we're just people. And my job is not a job. My career is not even really a career. I think of it as the way that I express myself creatively. You know, I'm not, I can't paint.

Kat McDavitt: Don't, I don't have any skills either,

Miriam Paramore: so, there's no other skills, but I love solving problems and I love the power of information in, in healthcare. And I love helping people. I love building teams. I love helping people rise up in their own career and creating something out of nothing, just because it's a business.

It's still an act of creation. So, it's a creative process for me. And this type of thing is really brings me a lot of joy. I'm very grateful for this.

Kat McDavitt: Well, we have been chit chatting for almost 60 minutes straight. I have one, well, I actually have two more questions for you, but I had them together because I like to take the edge off because I'm going to make you tell, I'm going to make you tell everyone about something amazing you have accomplished, but you can say before, after what is like your biggest bomb?

Miriam Paramore: Yeah. I was thinking about this and I thought of a very philosophical answer Kat that was going to be, you know, I don't think I've had any failures because everything is just a lesson. But I have had failures and I've had the biggest sort of the biggest business case, hard case I can think of was when I was about a year into my consulting business and I had sold a pretty big project to a large health system, and I had no way to actually deliver the project.

Like it needed five or so people who had some specific technical expertise and I was using my network and I said, Hey, do you have like people that have these skills and this person said, yes, So I contracted and go into delivery. Well, turns out those people, either weren't available, were incompetent, dropped the ball, any number of things, bottom line, I could not deliver.

And you know, the wheels were falling off and I was trying to kind of make it and I was so mortified. I thought, you know, this. Does it ever have, you know, people don't do this. People don't put their name. I don't put my name on something and not deliver, always do what I say, but I had just gotten a little bit over my head, you know?

And what I did, what it forced me to do was have an honest conversation with the client and say, look I'm sorry. I had these resources lined up. I thought we were going to be able to deliver in this timeframe. And we can't. And I'm sorry. And it hurts so bad. And then I just had to let it go, but I felt like a total incompetent, the thin, what I learned from that was a little bit more about how to think through, it's not really a trust issue, but sometimes your suppliers or your other labor people, it does fall apart.

Sometimes it happens. So that was a big one and it was my name, my company. So, it kinda hurt, but it wasn't that big of a deal, you know, they were like, well, Okay know, you suck, it's not the outcome, you know, the world. And I was terrified because I thought I'll never get another client.

They'll call everyone in the universe and say don't ever contract with her in her company because she'll drop the ball, but that didn't happen. And it was a unique situation in terms of my, you know, a big victory or win for myself. Th the thing that I thought about that too. So, I thought about what I'm going to say.

That'd be like the biggest numbers associated with it. Be awesome. Look right on spreadsheet. And I'm done to some of those things, but the the thing that has the most personal value to me, Business accomplishment is when I was running strategy at Emdeon. You were working I think helping us at the time.

But I had this passion for electronic funds transfer, replacing paper checks. And I think I still have that paper check on up here, but I, sometimes healthcare requires legislation and regulation to actually change and adopt a technology. So, it was when the Affordable Care Act was getting written and I was able to work with the lobbyists.

Go to Washington, just like on School House Rock on just you know, there's one paragraph in the Affordable Care Act administrative simplification provision that I wrote. And I figured out that $11 billion with a B. Was wasted every single year because payers were reimbursing providers, you know, or on a paper check basis.

And that was because of the industry in a rush to just take electronic funds transfer just like you and I do with direct deposit doctors and hospitals, weren't taking that. From payers and it was costing $11 billion a year. And you know, putting that into human terms at the time that would have vaccinated every girl in the world from zero to 18, with the three-part Gardasil vaccine for cancer.

That was new at the time. That's how much money that is related to a human and you know, that made a difference. You know, it may make a difference.

Kat McDavitt: I'm gonna interrupt you and say that to this day the U S healthcare efficiency index, which was part of your advocacy campaign to, to get that done, to get that policy written it's still kind of a classic example in public affairs and PR agencies have like, This was an amazing thing that this team pulled off.

And they did all of this advocacy work and like very impressive. I still talk about it to this day to whenever, or someone's like, we need to make a law or something like that. And I was like, well, yeah, what Miriam Paramore did.

Miriam Paramore: Yeah. You know, you don't think about it. You think you so it's a great, it's a great use case here. I am the other girl.

So educate, you know, while blah, blah, but you actually, you can do it like you can do it. You can go to Washington. And find a way to talk to the right people and you can make a case and it can happen. And, you know, lay my flag and everything. God bless America. But that ties it all together for me, you know, the network HIMSS, understanding legislation and regulation, how it, of how policy impacts our health care practice, public relations, government affairs, investor relations, telling your story, what you do, what you help companies do.

Build company success have an exit like you did changes people's lives. Putting technology out there taking $11 billion of absolutely waste. Let's transfer it into healthcare or vaccines or, you know, something good things. It was a good thing.

I'll do that. And it's okay to do that in business and be a business woman and be proud of yourself.

And I, so again, it just gives me a lot of joy to be able to share that.

Kat McDavitt: Listen, that was the best wrap up I've ever heard. Thank you. Thank you for handling that for us. It was amazing. I got excited. I love it. I love it. Well, thank you, Miriam. You're awesome. We've talked forever, which I obviously love I'm sure everyone else loves it too, but thank you for spending some time with us.

 

About Miriam & Kat

Miriam Paramore,

President & Chief Strategy Officer, OptimizeRx 

Miriam’s professional mission statement is, “To improve the U.S. healthcare system through the power of information.” She has 30+ years of experience in healthcare and deep expertise in health data and health information technology. Miriam has held C-suite roles in several health IT companies, and during her tenure at Emdeon, she helped lead the company to over $1.2 billion in revenue and the largest health IT IPO at the time.  

Miriam is the architect of the U.S. Healthcare Efficiency Index™, and the author of certain provisions of the Affordable Care Act focused on efficiency and savings through the use of health IT. She’s also a board member of Medsphere and has held many other board positions including at: CareSource, HIMSS, the Louisville Health Information Exchange, and the eHealth Committee for the Commonwealth of Kentucky. Miriam is an active angel investor and a senior advisor at NueCura, a Nashville-based healthcare angel investment company. She frequently advises venture capital and private equity firms, and is actively involved with other women-empowering organizations including: WBL (Women Business Leaders in Healthcare), Women in HIT (HIMSS) and CSweetner (a HLTH Foundation Program). She is the executive sponsor of the OptimizeRx Diversity and Inclusion Committee.

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