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Position Objective: Provides ambulatory care pharmacy services to patients in anticoagulation, primary care, and specialty clinics (e.g., endocrinology, cardiology) with a focus on Medication Therapy Management (MTM) and/or Collaborative Drug Therapy Management (CDTM).  This care entails assessment of learning needs, education on all aspects of the specific disease states such as diabetes, heart failure and oral anticoagulant medication (importance of compliance, food and drug interactions, activity considerations, and communication with the clinic), point-of-care testing such as INR lab value, assessment of lab value, medical and medication history review, critical thinking in the determination of a new treatment plan, communication of the treatment plan to the patient, and accurate documentation of the patient encounter in the Electronic Medical Record. Essential Job Duties: Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions  Participates in the establishment of goals and objectives for the Department, as a member of the Pharmacy team and represents Pharmacy through participation in hospital patient care teams and committees as needed. Assists in developing, implementing, maintaining and monitoring department initiatives to achieve departmental service metrics; including follow-up, to assure desired results are obtained. In collaboration with Pharmacy leadership, enhances patient-related drug therapy.  Develops, implements and evaluates evidenced-based medicine, treatment guidelines, protocols, pathways, initiatives and/or clinical programs that promote appropriateness and cost-effectiveness of medications. Reviews written medication orders and prescriptions, or medication history, to determine appropriateness of ingredients, strength, and dosage.  Reviews the medication selected relative to potential allergies, food/drug interactions, route of administration, toxicity, and adverse drug reactions with other medications ordered. Identifies, resolves, and prevents potential and actual drug-related problems by obtaining and evaluating medical data, including but not limited to: patient history, laboratory data, progress notes, and reviews patient EMR for drug interactions, allergies and contraindications, to determine and implement optimal drug therapy. Contacts the prescriber, as appropriate, to clarify orders, manage off-protocol situations, manage compliance issues, manage urgent/emergent situations, and/or make other recommendations concerning clinic therapies. Reviews referrals from physicians to the Clinic to ensure appropriateness from a clinical, as well as corporate compliance, standpoint. Maintains complete and accurate records as required by departmental policies and procedures and/or federal and state board regulations, including the documentation and investigation of all reported Hospital-related adverse drug reactions, in conjunction with the staff pharmacists. Assists with providing, coordinating and evaluating staff clinical knowledge/skills/competencies for developmental opportunities.  Provides in-service education to pharmacists and professional staff directed towards the AAMC patient population and/or clinical drug use initiatives. Assists in the growth and development of pharmacists, students and medical staff through mentoring and education.  Provides necessary training and support to pharmacy staff, students and residents for their developmental level, the requirements of the position and in the context of the needs of patients and hospital staff. Provides duties of Staff pharmacists job description, other assigned duties or upon request. Additional job functions as delineated per assigned position Educational/Experience Requirements: Doctor of Pharmacy degree or an equivalent demonstration of general clinical pharmacy expertise. ASHP Accredited Residency or Board Certification such as BCPS