Pharmacogenomics Clinical Pharmacy Practitioner (CPP) Provider The Clinical Pharmacy Practitioner (CPP) functions at the highest level of clinical practice and top of licensure and serves as an advanced practice provider working independently, but collaboratively, with prescribing privileges as outlined in the individual's practice area-based scope of practice. Basic Requirements: United States Citizenship: Non-citizens may only be appointed when it is not possible to recruit qualified citizens in accordance with VA Policy. Education: Graduate of an Accreditation Council for Pharmacy Education (ACPE) accredited College or School of Pharmacy with a baccalaureate degree in pharmacy (BS Pharmacy) and/or a Doctor of Pharmacy (Pharm.D.) degree. NOTE: Prior to 2005 ACPE accredited both baccalaureate and Doctor of Pharmacy terminal degree program. Today the sole degree is Doctor of Pharmacy. Graduates of foreign pharmacy degree programs meet the educational requirement if the graduate is able to provide proof of achieving the Foreign Pharmacy Graduate Examination Commission (FPGEC) Certification, which includes passing the Foreign Pharmacy Graduate Equivalency Examination (FPGEE) and the Test of English as a Foreign Language Internet-Based Test (TOEFL iBT). Licensure. Full, current and unrestricted license to practice pharmacy in a State, Territory, Commonwealth of the United States (i.e., Puerto Rico), or the District of Columbia. English Language Proficiency. Pharmacists must be proficient in spoken and written English as required by 38 U.S.C. 7402(d), and 7407(d). Grade Determinations: GS-13 Clinical Pharmacy Specialist Experience: In addition to the GS-12 requirements, must have 1 year of experience equivalent to the next lower grade level, GS-12.The GS-12 requirements include: 1. Knowledge of professional pharmacy practice. 2. Ability to communicate orally and in writing to both patients and health care staff. 3. Knowledge of laws, regulations, and accreditation standards related to the distribution and control of scheduled and non-scheduled drugs and pharmacy security. 4. Skill in monitoring and assessing the outcome of drug therapies, including physical assessment and interpretation of laboratory and other diagnostic parameters. AND Knowledge, Skills, and Abilities: Pharmacists assigned to this position must demonstrate the following KSAs: a. Ability to communicate orally and in writing to persuade and influence clinical and management decisions. b. Expert understanding of regulatory and quality standards for their program area. c. Ability to solve problems, coordinate and organize responsibilities to maximize outcomes in their program area or area of clinical expertise. d. Expert knowledge of a specialized area of clinical pharmacy practice or specialty area of pharmacy. e. Advanced skill in monitoring and assessing the outcome of drug therapies, including physical assessment and interpretation of laboratory and other diagnostic parameters. References: VA HANDBOOK 5005/55 PART II APPENDIX G15 The full performance level of this vacancy is GS-13. ["VA Careers - Pharmacy: https://youtube.com/embed/Fn_ickNBEws Duties include, but are not limited to: Clinical - Direct Patient Care Activities 1) Functions as an advanced practice provider for CMM services to achieve defined outcomes through direct interactions with patients and providers in assigned care area(s). 2) Functions as part of the interdisciplinary team to provide PGx-based CMM, which may include, but is not limited to: a. Prescribes, monitors, and adjusts medications related to PGx management b. Obtains pertinent medical history and obtains accurate medication related history and PGx family history from patient and via chart review c. Obtains oral informed consent and documents this encounter in the electronic medical record d. Orders PGx testing when indicated to aid in the process of medication and dosage selection or deprescribing e. Monitors, and interprets pharmacogenomic results and other needed labs; implements follow up on treatment actions as clinically indicated f. Evaluates third party pharmacogenomic testing results to determine clinical validity and utility for the Veteran served g. Utilizes race-agnostic PGx dosing guidelines and algorithms in accordance with PharmGKB statement on eliminating race-based medicine h. Identifies and reconciles drug-gene, drug-gene-disease, and drug-drug-gene (i.e., phenoconversion) interactions i. Ensures PGx testing and test results are handled in an ethical manner---also considering social and legal implications---and that patients are provided access to their genetic data when applicable j. Designs patient-specific medication and dosage regimens based on a person's PGx profile and other pertinent factors, such as pharmacokinetic and pharmacodynamic properties of a medication, drug-drug, and drug-gene interactions, comorbidities, patient demographics, and laboratory data to optimize patient outcomes k. Provides resources and education that empower patients to make informed healthcare decisions about undergoing PGx testing and understanding their test results l. Ensures referral of complex or unstable patients to higher level care, when needed m. Communicates with team for next steps and coordination of care, when necessary 3) Performs limited external physical assessment and performs medication reconciliation in alignment with established policies or procedures 4) In addition to PGx management, provides CMM for complex patients with chronic diseases; 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). 5) Determines if a referral to a physician is necessary when disease progression occurs, or adverse drug events require a higher level of treatment intervention 6) 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. 7) Follows up via face-to-face, telehealth, eConsult, telephone, secure messaging, and other modalities to provide patient care Clinical - Indirect Patient Care Activities 1) 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 2) Facilitate the creation of pharmacist-led specialty PGx services using either consult, e-consult, or care coordination agreement (CCA) functionality 3) Monitors and reports drug errors, adverse drug reactions, allergies, and patient compliance issues. Documents findings per facility procedures and in accordance with the VAADERS Adverse Drug Reaction (ADR) reporting program 4) Reviews relevant population management dashboards to identify patients who may benefit from engagement in care for PGx testing, management, and/or risk mitigation 5) 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 Work Schedule: Full-time; 40 hours/week Telework: If approved, will be on an ad-hoc basis Virtual: This is not a virtual position. Functional Statement #: 000000 Relocation/Recruitment Incentives: Not authorized Permanent Change of Station (PCS): Not authorized Financial Disclosure Report: Not required"]

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