Clinical Pharmacist Specialist

Advanced Practice Provider For Comprehensive Medication Management

Functions as an advanced practice provider for the Comprehensive Medication Management (CMM) to achieve defined outcomes through direct interactions with patients and providers in assigned care area(s). Functions as part of the interdisciplinary team to provide CMM for pain management which may include, but is not limited to:

Clinical - Direct Patient Care Activities

• Prescribes, monitors and adjusts medications related to pain management
• Obtains pertinent medical history and obtains accurate pain medication related history from patient and via chart review
• Orders, monitors, and interprets toxicology screens and other needed labs; implements follow-up on treatment actions as supported by lab interpretations
• Performs rating scales on pain control, symptoms and functional status
• Queries and documents POMP findings
• Provides overdose education and prescribes naloxone when needed
• Provides patient and/or caregiver instructions and education
• Uses available population health tools to identify and address risk mitigation needs focused on safe pain care
• Performs suicide risk assessment
• Screens for substance use disorders when indicated, performs brief interventions when indicated, including addressing aberrant behaviors
• Ensures referral of complex or unstable patients to higher level care, when needed
• Address other care needs and refers patients to other services for other needed care, as deemed appropriate (e.g., mental health/PC Behavioral Health, physical therapy, yoga, etc.)
• Communicates with team for next steps and coordination of care, when necessary

Performs limited external physical assessment and performs medication reconciliation in alignment with established policies or procedures.

In addition to pain management, provides CMM for complex patients with chronic diseases including, but not limited to, alcohol misuse/use disorder and tobacco misuse/use disorder; orders and interprets labs or other needed tests pertinent to CMM and makes needed referrals. May also treat other co-morbid conditions (in alignment with scope of practice).

Determines if a referral to a physician is necessary when disease progression occurs, or adverse drug events require a higher level of treatment intervention.

Accepts urgent or same day patient visits including, but not limited to, patient medication review for polypharmacy, recent hospital or emergency department discharges, and co-managed care patients.

Follows up via face-to-face, telehealth, eConsult, telephone, secure messaging and other modalities to provide patient care.

Clinical - Indirect Patient Care Activities

• Reviews patient medication regimens for clinical effectiveness, drug selection, dosing, contraindications, side effects, potential drug interactions, and therapeutic outcomes as required
• Communicates findings with prescribers and provides appropriate recommendations for alternatives to current treatment plans as needed
• Monitors and reports drug errors, adverse drug reactions, allergies, and patient compliance issues
• Reviews relevant population management dashboards to identify patients who may benefit from engagement in care for pain management and/or risk mitigation
• Applies knowledge to interpret laboratory values in the evaluation of patient care, recognizes significant abnormalities, and makes dose adjustments or recommendations based on objective laboratory findings
• Provides input and recommendations as the pain medication expert on the interdisciplinary pain management team during routine patient care planning or targeted complex or high-risk reviews
• Assists the Pharmacy and Therapeutics (P&T) committee with medication use evaluations and other safety initiatives, as needed
• Documents clinical interventions and patient care encounters in the electronic health record in a timely and professional manner as appropriate
• Works with providers to ensure compliance with national, VISN, and local initiatives (e.g., OSI)

Work Schedule: Monday-Friday 8:00 am to 4:30 pm (Subject to change based on the needs of the service).

Telework: Available

Virtual: This is not a virtual position.

Functional Statement #: 564-00915-F

Relocation/Recruitment Incentives: Not Authorized

Permanent Change of Station (PCS): Not Authorized