Manjula D. Jayabalan, Pharm.D., MBA | 2026 MHE Emerging Leaders in Healthcare

I was born in Kuwait, and my family eventually moved to the Metro Detroit area, where I completed my education from middle school through my undergraduate studies. Growing up in a multicultural household and having lived in three different countries before starting college certainly shaped who I am today. My immigrant parents instilled in me the value of excellence and a strong work ethic. These principles continue to guide how I approach my work and leadership today.

I attended the University of Michigan-Dearborn, where I pursued a dual degree, earning a Bachelor of Science in biology and a Bachelor of Arts in psychology. I went on to earn my Pharm.D. from Lipscomb University College of Pharmacy in Nashville, Tennessee, and later completed my MBA at the University of the Sciences in Philadelphia. I wasn’t always certain about the exact path I wanted to pursue, but it was important to me that my work be intellectually engaging, challenging and unique in nature. This curiosity led me to eventually pursue managed care pharmacy as my career path and complete a PGY1 residency at BlueCross BlueShield of Tennessee.

Over the course of my career, I’ve acquired experience across health plans, PBMs [pharmacy benefit managers], employer consulting and pharmaceutical manufacturing. My work has spanned clinical program development, formulary and utilization management, account management, government affairs, health policy, and health equity. In my current role as senior director of pharmacy at Willis Towers Watson, I serve as a trusted adviser to employer groups, guiding the design, selection and optimization of pharmacy benefits and formulary strategies to drive value and improve outcomes.

Turning point in your career

A pivotal turning point in my career came when I was selected to participate in executive leadership development programs. These experiences broadened my perspective beyond my immediate role, giving me exposure to diverse functions across the organization. I worked on enterprise-wide initiatives that required balancing the priorities, constraints and perspectives of multiple cross-functional teams. This deepened my understanding of how different parts of the organization operate and strengthened my ability to think strategically and collaboratively.

These experiences also shaped how I think about leadership. One piece of advice that stayed with me was that effective leaders don’t just provide answers; they create clarity, align stakeholders and enable others to succeed. That shifted my approach from focusing primarily on my own contributions to thinking more intentionally about how to bring people together, navigate competing priorities and drive collective outcomes.

Biggest day-to-day challenges

I work closely with employer clients who are navigating an increasingly complex and high-cost pharmacy landscape while also carrying the fiduciary responsibility to manage benefits prudently and in the best interest of their employees. We often have limited transparency into PBM pricing, rebate structures and savings calculations, which makes it difficult to fully assess whether we are receiving a fair value. In my role, I focus on helping clients bring clarity to this complexity so they can make informed decisions that align with both their fiduciary responsibility and their commitment to employees. My goal is to support employers in designing pharmacy benefits that are sustainable, ensuring members have access to the medications they need while employers can feel confident they are managing their pharmacy programs with integrity and accountability.

Use of AI

I’m incorporating AI [artificial intelligence] into my work in an efficiency-driven way, primarily as a tool to reduce low-value effort and free up more time for higher-impact strategic work. AI helps me distill large amounts of information, whether it’s market trends or industry data, into clear insights that I can then refine and apply. This reduces the time spent on initial drafting and allows me to focus more on interpretation and decision-making.

I also use AI to improve communication efficiency and quality. It helps me draft and refine messaging so that ideas are clearly articulated to others. AI also helps me in problem-solving and scenario thinking; [I’m] using it as a thought partner to explore different angles, test assumptions and pressure-test ideas more quickly than traditional methods allow. Overall, my approach is to use AI as an enabler of efficiency: streamlining execution, enhancing clarity and freeing up capacity to focus on key decision-making that requires human judgment.

Top priority

My top priority this year and into the next is to continue broadening my expertise so I can lead with greater impact. I’m focused on staying attuned to evolving industry trends to support more informed, strategic decision-making. Equally important to me is continuing to mentor and develop others. As I grow within my career, I see it as a responsibility to invest in those around me and help build their capability, confidence and future leadership potential. This focus allows me to contribute not only to my own growth but also to the strength and success of the broader team and organization.

Recommended book, article, podcast, TV show or documentary

“The Checklist Manifesto” by Atul Gawande. This book is especially relevant to healthcare because it highlights how something so simple as a checklist can greatly enhance safety, reduce errors and improve outcomes in very complex environments. Gawande draws on real-world examples from surgery, aviation and construction to show that errors often occur not due to lack of expertise but due to failures in clear communication and process.

What makes it particularly valuable for healthcare professionals is its reliability in complex environments. The book emphasizes the importance of standardization, teamwork and structured processes in delivering high-quality care. It shows that improving care does not always require breakthrough innovation; often, it requires better execution of known best practices.

Making U.S. healthcare less expensive

U.S. healthcare costs are high in general, but prescription drugs are one of the most visible drivers of that expense. In the U.S., drug prices are largely set by manufacturers and then negotiated through a complex chain of insurers, PBMs, pharmacies, and public programs such as Medicare and Medicaid. Unlike many other wealthy countries, there is no single national authority that directly sets or tightly regulates most drug prices, so manufacturers often have substantial pricing power, especially for brand-name and specialty medications with limited competition.

Another major factor is misaligned PBM incentives combined with limited transparency. PBMs negotiate rebates, formulary placement and utilization controls, but compensation is often tied to rebate volume, spread pricing or list-price benchmarks rather than minimizing net cost. This can create misaligned incentives where higher list-price, higher-rebate drugs are favored over lower net-cost alternatives and where the true net price after rebates is not fully observable to plan sponsors. The lack of PBM transparency around rebate retention and formulary economics makes it difficult to verify whether savings are fully flowing to their clients and patients or being partially captured within the PBM contracting stack.

Competition in the pharmaceutical market is also uneven. While generic drugs usually tend to be inexpensive in the U.S., brand-name drugs, especially biologics and specialty medications, can remain expensive for years. Barriers to entry, patent protections and complex regulatory pathways delay competition, limiting price reductions that would normally come from multiple manufacturers entering the market.

Meaningful fixes to these issues would likely require legislative action that makes certain practices illegal, such as nontransparent rebate retention, spread pricing and failure to pass through negotiated savings, while establishing enforceable transparency requirements, backed by strict penalties for violations. These legislative efforts should focus on mandating price transparency across the drug supply chain, limiting excessive price growth, accelerating generic and biosimilar competition, eliminating spread pricing, and tightening alignment between incentives and net cost.

Personal goal

Outside of work this year, I want to focus on a few simple experiences that bring more balance into my routine. One is cooking more intentionally at home and experimenting with new fusion recipes. Growing up in Kuwait, I enjoyed Arab-Indian fusion dishes made by my mother and grandmother, and I now want to incorporate British cuisine into my cooking to honor my husband’s heritage and create dishes that reflect both of our backgrounds.

I also want to continue traveling, focusing on new destinations I haven’t yet visited. I love learning about different cultures, cuisines and ways of life, and I want to be more intentional about making time for those experiences.

I want to set that example myself, showing them that it’s OK to struggle through something new. Right now, I’m thinking about learning how to play drums. It’s definitely out of my wheelhouse, but that’s kind of the point.