Clinical Pharmacist - Ambulatory Care ​/ COPD Population Health Program

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The Clinical Pharmacist provides ambulatory pharmaceutical care services within the Rhode Island Primary Care Physicians Corporation (RIPCPC) ACO. The pharmacist is embedded within primary care practices and collaborates as part of the interdisciplinary care team to provide evidence-based, patient-centered medication management focused on optimizing medication regimens, improving chronic disease outcomes, and reducing avoidable healthcare utilization.

This position will support a pharmacist-led COPD population health program focused on high-risk patients with chronic obstructive pulmonary disease (COPD), including transitions of care management, medication optimization, inhaler education, adherence support, and early exacerbation intervention. In addition to COPD-focused responsibilities, the pharmacist will support broader ambulatory care pharmacy services and organizational quality initiatives based on program needs and operational priorities.

The Clinical Pharmacist ensures the safe, effective, evidence-based, and cost-conscious use of medications while promoting high-quality patient care. The pharmacist also serves as a medication and drug information resource for patients, providers, and interdisciplinary care team members.

Duties and responsibilities include, but are not limited to:

• Functions as the medication expert on the interdisciplinary care team.
• Reconciles and assesses medication regimens for adherence, safety, effectiveness, and optimization of therapy to achieve desired clinical outcomes.
• Provides evidence-based, patient-centered medication therapy recommendations in collaboration with providers and care team members.
• Delivers chronic disease state management services with emphasis on COPD guideline-directed therapy, inhaler technique education, adherence monitoring, and mitigation of medication access barriers.
• Identifies and engages high-risk COPD patients through population health and care management platforms, including patients with recent emergency department visits, hospital admissions, or readmissions.
• Conducts transitions of care medication evaluations following acute care encounters and coordinates follow-up care with primary care teams and other providers as appropriate.
• Educates patients on medications, disease states, self-management strategies, and recognition of early COPD exacerbation symptoms to support timely intervention and reduce avoidable acute care utilization.
• Practices within established collaborative practice agreement(s) consistent with services delineated within the agreement.
• Collaborates with providers, patients, payers, and care management teams to ensure high-quality, cost-effective care.
• Participates in the development, implementation, and evaluation of quality improvement initiatives and population health programs.
• Contributes to achievement of contractual and organizational quality goals, including but not limited to comprehensive medication reviews, medication adherence outreach, transitions of care initiatives, and gaps in care closure.
• Documents all patient encounters and interventions within the electronic health record and other required platforms while maintaining timely communication with interdisciplinary team members.
• Assists in the collection, tracking, and reporting of program outcomes and quality metrics including utilization, engagement, and clinical outcomes.
• Develops and delivers presentations related to quality…