Clinical Pharmacist

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Company: Oak Street Health

Title: Clinical Pharmacist, Chronic Condition Management

Location: Remote (license required in AL/IA/AR or within 60 days of hire)

Job Code: 413210 - Clinical Pharmacist

Oak Street Health is a rapidly growing company of primary care centers for adults on Medicare in medically-underserved communities where there is little to no quality healthcare. Oak Street's care is based on an entirely new model that is based on value for its patients, not on volume of services. The company is accountable for its patients' health, spending more than twice as long with its patients and taking on the risks and costs of their care.

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The Clinical Pharmacist, Chronic Condition Management is an integral member of the primary care team, responsible for optimizing medication therapy, improving chronic disease outcomes, and supporting the management of high-risk, medically complex patients. The pharmacist will be expected to provide direct patient care, support population health initiatives, and work under a collaborative practice agreement (CPA), where permissible.

Direct Patient Care

• Provide comprehensive medication management (CMM) for patients with chronic conditions such as diabetes, hypertension, heart failure, COPD, asthma, hyperlipidemia, and anticoagulation.
• Conduct telehealth (or face‑to‑face, if applicable) visits to assess medication efficacy, safety, adherence, and patient understanding.
• Develop individualized care plans in collaboration with an interdisciplinary care team, including physicians, advanced practice providers, nurses, and care coordinators.
• Provide patient education on disease states, medications, and self‑management strategies.
• Ensure the appropriateness of drug therapy based upon patient’s diagnosis, the correctness of the dosing of medications based upon the patient‑specific parameters, and promote selection of the most cost‑effective medications that attain the desired therapeutic outcomes.
• Interpret laboratory and other patient‑specific data to develop treatment plans and to monitor response to therapy.
• Issue recommendations to the patient’s managing medical team regarding therapies or alternative approaches based on interpretation of relevant medical literature and clinical experience.
• Where permissible, manage patients under collaborative practice agreements, including initiation, adjustment, and discontinuation of medications.

Clinical Program Development and Population Health

• Identify and engage high‑risk or high‑cost patients through population health tools, risk stratification reports, or EMR dashboards.
• Participate in quality improvement initiatives focused on chronic disease metrics (e.g., A1c control, blood pressure goals, medication adherence).
• Collaborate with care teams to reduce hospital readmissions and emergency department utilization.
• Develop and maintain clinical protocols, workflows, and documentation templates to support pharmacist‑led services.
• Track and report clinical outcomes, intervention metrics, and quality measures.

Interdisciplinary Collaboration

• Serve as a medication expert on the primary care team, providing evidence‑based recommendations for complex medication regimens.
• Communicate clinical interventions and care plans effectively through the EMR and team huddles.
• Participate in care team meetings and provider education sessions.
• Make verbal or written recommendations in a clear, succinct and appropriate manner.
• Ensure a continuum of care by cooperating with other health professionals and outside health organizations.

• Strong clinical judgment and evidence‑based decision making.
• Excellent communication and interdisciplinary collaboration…