Miriam Cho’s children are her greatest motivation. It’s a simple, deeply human fact that underpins a career of remarkable complexity and success. As the President and Chief Pharmacy Officer of MAC Rx, she oversees a multi-state long-term care pharmacy operation serving over 30,000 individuals in the Midwest. She navigates the labyrinthine worlds of Medicare Part D, the Inflation Reduction Act, and the opaque practices of Pharmacy Benefit Managers. But to understand how she got here, you have to look past the C-suite titles and the impressive growth charts. You have to go back 21 years, to a young pharmacy student on a traditional path, and a single phone call that would change everything.
Her story is not one of a meticulously planned ascent. It is a story of a happy accident, of a woman who, in seeking a better work-life balance for her family, stumbled into an industry she knew little about and proceeded to revolutionize it from the inside out. As the daughter of first-generation immigrants, she is driven by a desire to provide her children with opportunities she never had. This quiet, powerful motivation has fueled her transformation of a fledgling pharmacy into a thriving enterprise, built not on cutthroat tactics, but on a radical commitment to service, personal connection, and the belief that in the high-stakes world of healthcare, the most valuable currency is trust.
The Unplanned Detour
Twenty-one years ago, Miriam Cho was doing what was expected. She was finishing her Doctor of Pharmacy at Midwestern University in Illinois and embarking on a career in corporate retail pharmacy. It was a well-trodden path, stable and secure. But it didn’t take long for her to realize that it didn’t align with her goals. The corporate world felt impersonal, the trajectory unfulfilling.
The turn came unexpectedly. A former colleague reached out about an opportunity at a newly established pharmacy called MAC Rx. Miriam knew next to nothing about long-term care, but the promise of a better work-life balance for a mother of three was a powerful lure. She explored the opportunity and was hired. Upon arriving, her sharp eye for operations immediately identified areas for improvement. A few months later, in December 2015, she was offered the position of Pharmacist in Charge and Director of Pharmacy. She accepted. The following year, she was promoted to Chief Pharmacy Officer.
What happened next was nothing short of explosive. Under her leadership, the pharmacy began to experience staggering growth, achieving a 48% year-on-year increase since 2016. In 2021, MAC Rx expanded, acquiring a second location in Indiana. This was followed by the launch of a new startup in Missouri in June 2023. The woman who had entered the industry by chance was now leading its charge across the Midwest.
The Gospel of Service
Ask Miriam Cho to name her company’s priorities, and she will tell you it is a service-first approach, with cost savings as a close second. “Exceptional service is the most important,” she says, without hesitation. In the complex, often impersonal world of long-term care, MAC Rx has built its success on a foundation of human connection. Miriam believes in being a “true partner” to her clients, which means being present on the front lines, not just in the boardroom.
This philosophy manifests in ways that are almost unheard of in a large industry. Many of MAC Rx’s partners have Miriam’s personal cell phone number, along with the contact information for other members of her leadership team. This level of accessibility fosters a deep sense of trust and partnership. It is a strategy of radical transparency and personal touch in a sector that can often feel bureaucratic and distant. This commitment to building personalized relationships is not just a strategy; it is the core of her business, and she credits it with the company’s impressive client retention rates.
Navigating the Maze
The healthcare and pharmaceutical landscape is a constantly shifting maze of legislation and regulation. One of the most significant current challenges is the implementation of the Inflation Reduction Act (IRA), which is introducing sweeping changes to reimbursement structures. While many in the industry view these changes with apprehension, MAC Rx has taken a proactive stance. Miriam’s approach is not to wait and see, but to advocate, engage with policymakers, and educate them on the vital role that long-term care pharmacies play in serving vulnerable populations.
At the state level, the challenges are compounded by reimbursement legislation that often puts financial authority in the hands of Pharmacy Benefit Managers (PBMs), entities that, as Miriam points out, exert significant negative control over the financial landscape. Navigating these complexities requires a deep understanding of the industry and a willingness to challenge the opaque practices of PBMs. It is a fight for transparency, not just for her own pharmacies, but for the health of the broader system.
The Greenhouse for Growth
Miriam Cho’s leadership style is that of a cultivator. She is deeply invested in the growth of her team, a passion that is on full display at the company’s quarterly off-site leadership conferences. “I find motivation in helping individuals thrive and succeed within the organization,” she says. This focus on internal development is matched by a relentless drive for innovation.
MAC Rx was one of the first pharmacies to hire nurses as part of its customer service team, a move that integrated essential clinical skills directly into the service model. The company has also started offering accredited webinars to its nursing facility partners, further cementing its role as an educational partner. Now, she is pushing the company into the future, with a strong emphasis on automation and AI innovation. “I am eager to see the results and customer responses as we begin to roll out these advancements in Q3 and Q4 of this year,” she says with palpable excitement. Her vision is clear: to leverage technology to improve clinical outcomes, enhance efficiency, and minimize the potential for human error.
The Unspoken Superpower
In a field where leadership panels and boards often lack female representation, Miriam has carved her own path. “As a minority female who is not particularly tall, I have always focused on my strengths and contributions rather than my physical appearance,” she says. She believes firmly in the value that women bring to decision-making, often quoting Ruth Bader Ginsburg on the importance of having women in any room where decisions are made. Women, she believes, approach challenges differently, offering unique insights that lead to better, more collaborative outcomes.
This belief has resulted in a workforce at MAC Rx that is remarkably diverse. Miriam notes that the teams feel almost global in their composition, a result not of intentional quotas, but of a simple, powerful hiring philosophy: hire the best individuals with the right values, drive, and intentions. By focusing on talent and character, the company has built an environment where race and gender are secondary, and a culture of true inclusivity has blossomed organically.
In the end, Miriam Cho’s story is a powerful testament to the idea that the greatest professional successes are often fueled by the most personal motivations. For her, it all comes back to her children, to the immigrant drive to build a better life. “For those who know me, it’s clear that I often talk about my kids,” she says. By prioritizing her family, she has found the focus and grounding to build a thriving business. Her advice to aspiring women professionals is a reflection of her own journey: take bold and confident steps. “The worst that can happen is someone tells you ‘no,’” she says, “but at least you can say you tried.” It is a philosophy that has served her well, a leap of faith that turned an unplanned detour into a remarkable journey to the forefront of an industry.
Also read: The Most Inspiring Women Leaders in Healthcare 2025
