Women Of The C-Suite: Susan Lang Of XIL Health On The Five Things You Need To Succeed As A Senior Executive

Stand your ground, articulate your positions and ask for the right compensation.

As a part of our interview series called “Women of the C-Suite,” we had the pleasure of interviewing Susan L. Lang.

Susan L. Lang founded XIL Health, a leading, woman-owned health analytics and technology company. As CEO, Lang works with startups as well as Fortune 100 PBMs, health plans, drug manufacturers and retail pharmacy companies. Lang has a robust knowledge of pharmaceutical economics and healthcare technology and is passionate about helping companies compete by leveraging disruptive technologies that redistribute drug economics to benefit consumers.

Thank you so much for joining us in this interview series! Before we dig in, our readers would like to get to know you a bit more. Can you tell us a bit about your “backstory”? What led you to this particular career path?

I left a c-suite position at Express Scripts, a Fortune 100 company at the time, to launch my first startup called HooPayz. HooPayz was a patient advocacy health tech SaaS model that was completely bootstrapped. About 20 years ago I went from being a hospital administrator to a patient. I was hit head on by a drunk driver on my way to a hospital Board meeting. Experiencing the complexities of healthcare as a patient convinced me there has to be a better way.

Can you share the most interesting story that happened to you since you began leading your company?

We started without funding, so we “borrowed” a conference room at the local airport and met there 3–4 days a week for months. Many colleagues thought I was crazy to leave a c-suite position managing a $50B portfolio to create a “new business model” with three employees and no revenue. Within a year, old colleagues started calling asking for assistance with their business growth strategies. So we founded a second company, a health analytics and consulting firm, with zero investment that was profitable day 1. That taught me a lot about expanding my vision and expectations as well as how important your long term relationships are for your success.

Can you share a story about the funniest mistake you made when you were first starting? Can you tell us what lesson you learned from that?

The first question I had when starting a new company was “where is the IT guy?” You know, the one who sets up your emails and manages your technology devices. I had no idea how to create a corporate infrastructure. I eventually found my way to google and called a buddy in India to walk me through the setup process. It was really humbling but clearly, I needed to quickly hire for functions I could not do myself.

None of us are able to achieve success without some help along the way. Is there a particular person who you are grateful towards who helped get you to where you are? Can you share a story about that?

After I left Express Scripts, the chairman of the Board at Prasco Pharmaceuticals called me. His name is Tom Arington. Tom is an incredibly successful entrepreneur. Tom said come and see me before you make any career decisions. At our meeting we discussed the possibility of scaling HooPayz and Tom immediately agreed to be one of our first clients. He was incredibly encouraging and helped me understand the value I could bring to the market as a founder. Tom is still a good friend and colleague. His company, Prasco, was a client for 9 years until we sold HooPayz in 2021.

In my work, I often talk about how to release and relieve stress. As a busy leader, what do you do to prepare your mind and body before a stressful or high-stakes meeting, talk, or decision? Can you share a story or some examples?

I use a lot of visualization. I can see the outcome of the meeting, anticipate missteps and end the meeting with a positive outcome. In addition, I listen to really high-energy, upbeat music before walking into the meeting so I walk in with a positive vibe.

As you know, the United States is currently facing a very important self-reckoning about race, diversity, equality and inclusion. This may be obvious to you, but it will be helpful to spell this out. Can you articulate to our readers a few reasons why it is so important for a business or organization to have a diverse executive team?

Diverse executive teams create better outcomes, higher earnings and are more resilient than homogenous teams. Strategic debate centered on diverse experiences allow companies to find new strategies and solve problems in ways that would be missed otherwise. So, while many see this as a moral issue, it is absolutely a business issue. As a competitive leader, I want to win. Diversity and inclusion gives me that edge.

As a business leader, can you please share a few steps we must take to truly create an inclusive, representative, and equitable society? Kindly share a story or example for each.

Working for large organizations, policies point to diversity, but the practice is typically missing. Creating space in middle management and then sponsoring leaders to move to the executive level is critical. The visual impact of a diverse team gives other leaders permission to promote people that are not like them. At XIL Health, we hire diverse teams and then give them a company wide project to improve their visibility across functions. We also promote based on potential, not just experience. While that has always been true for white men, it is generally not the case for women and minorities. We usually make them prove over and over again their worth. That wastes time and is destructive to the team.

Ok, thank you for that. Let’s now jump to the primary focus of our interview. Most of our readers — in fact, most people — think they have a pretty good idea of what a CEO or executive does. But in just a few words can you explain what an executive does that is different from the responsibilities of the other leaders?

My job as CEO is to grow the company. That doesn’t mean higher sales targets but rather how to grow into new products, markets, mergers, and acquisitions. To achieve growth, leading an amazing team and being able to hold a diverse team together to push for the best outcome is critical. If the CEO does not have a growth vision, they cannot lead the company because they will fail. That is fundamentally different from other executive roles.

What are the “myths” that you would like to dispel about being a CEO or executive. Can you explain what you mean?

Many people think that being a CEO is glamorous and that you have teams to do your work, so you can play golf during the week. But the job itself is very challenging intellectually, emotionally and physically. The hours are very long and the job is never over. You don’t leave the office at 6pm and shut down for the night. Every large complicated issue hits your desk and ultimately your decisions decide the outcome for you, your employees, their families and your shareholders or investors.

In your opinion, what are the biggest challenges faced by women executives that aren’t typically faced by their male counterparts?

Women executives are constantly tested in ways our male counterparts are not. Other leaders feel justified in confronting women leaders even if they are at a much lower level in the organization. Women are frequently underpaid and underestimated. Building strong coalitions of support can assist, but women also need to master the skill of positive confrontation. Stand your ground, articulate your positions and ask for the right compensation.

What is the most striking difference between your actual job and how you thought the job would be?

I thought that building a great executive team would free up my time for strategy and funding. But holding great diverse teams together while dealing with the politics and egos that come with big positions is challenging. Also, I thought if we launched a great product and had a terrific sales group that the product would sell. But without constant promotion, nothing moves. So the job of CEO is really an endless string of problem solving, coupled with small and occasionally large wins here and there. It requires a toughness and stamina I was not expecting.

Do you think everyone is cut out to be an executive? In your opinion, which specific traits increase the likelihood that a person will be a successful executive and what type of person should avoid aspiring to be an executive? Can you explain what you mean?

I do not believe everyone is cut out to be an executive. Executives must be incredibly resilient, resourceful, competitive, and focused on winning to succeed in a hyper competitive business environment. Managers who strive for work/life balance, hate politics, are individual contributors, want to take a lot of time off, and don’t’ have physical stamina may want to stay away from an executive role. Executives have to build consensus, deal with constant pressure, build strong relationships, lead, fail, and try again all while someone else may be wanting to take their job. That is not for everyone.

What advice would you give to other women leaders to help their team to thrive?

The best thing you can do is to be present and authentic. Building loyalty and surrounding yourself with really smart people is critical. Empower your best team members by giving them large projects early in their careers and trust they will do well. And get comfortable with quickly firing anyone on the team that is not pulling their weight or is undermining the team’s efforts. Letting a failing team member remain in their position too long undermines your credibility with your team.

How have you used your success to make the world a better place?

I have tried to mentor both young men and young women. Several years ago, I was a founding member of the Women’s Leadership Forum at Washington University in St. Louis aimed at enhancing the skills for women leaders who want to move to the c-suite. When the university asked if I was willing to help, we were not sure if there was demand for this type of program. But we designed and launched it anyway. I taught one of the sections on women and politics for the first three years. Ten years later, the program has graduated several hundred women leaders who formed important relationships with other women leaders around the country. In addition, I have sat on several not for profit Boards in my community and sponsored several young women leaders.

What are your “5 Things I Wish Someone Told Me Before I Started” and why? (Please share a story or example for each.)

The first is you do not get what you do not ask for! Waiting for a promotion or new role is not the shortest path to success. When I was just starting out as a junior executive, I wanted a promotion for a new job opening. When I didn’t get the position (I never asked for it), my boss asked why I never mentioned I was interested.

The second issue is: always take the promotion — do not worry if you are ready. Reward does follow risk and you are as good as any other candidate. I have passed up a few good opportunities early in my career because I didn’t think I was ready.

The third thing I wish I knew is to trust my gut. My years of cumulative experience have sharpened my instincts. When I was younger I doubted my own opinion by believing others’ opinions mattered more. I remember launching a new product years ago against my better instinct and that product failed. It wasn’t ready for the market but I allowed myself to be talked into it by a colleague.

The fourth piece of advice is to make peace with being emotionally uncomfortable. If you feel uneasy, tense, unsure and it is something you want to do, embrace your feelings and do it anyway. I used to tell my team, if they don’t feel nauseous at least once a week they are not pushing hard enough.

And lastly, I would say to let go of disputes quickly. Hanging on to awkward conversations, bad feedback, re-interpreting gestures, etc. consumes energy and is a waste of time. Always look forward and allow anyone with whom you have a dispute to recover. It will help both of you.

You are a person of great influence. If you could inspire a movement that would bring the most amount of good for the greatest number of people, what would that be? You never know what your idea can trigger.

I would like to improve the health status for people around the world. The way I would do that is to combine better nutrition with low-cost generic drugs that have a single strength so they are cheaper to manufacture. Then through a low-cost subscription program, mail (or distribute) their meds and food to them on a weekly or monthly basis.

Can you please give us your favorite “Life Lesson Quote”? Can you share how that was relevant to you in your life?

“And still I rise” from the poem of the same name by Maya Angelou. So many times in my life and career I have been written off or underestimated. I had to change MBA programs in my early 20s due to a head trauma and my professors told me I was running my career, then when I left a VP position to work on another Masters degree, I was told I would not be able to advance, after my car accident in my 30s no one thought I could go back to work, and finally after leaving Express Scripts to found my first company everyone thought I was crazy. But still, at 60, I am founding a new health tech company with a Fortune 20 partner. So still I rise….

We are very blessed that some very prominent names in Business, VC funding, Sports, and Entertainment read this column. Is there a person in the world, or in the US with whom you would love to have a private breakfast or lunch with, and why? He or she might just see this if we tag them.

Malala Yousafzai. I think the work she is doing to educate girls around the world is incredibly important and I would love to assist in some way.

Thank you for these fantastic insights. We greatly appreciate the time you spent on this.