Upstream USA works to expand opportunity by reducing unplanned pregnancy across the U.S. We work in partnership with health centers to strengthen reproductive care and autonomy by increasing equitable access to the full range of contraceptive options.

Founded in 2014, Upstream is on track to achieve nationwide impact at scale. Our goal through 2024 is to partner with health centers that serve over 1 million women across four states. This ambitious plan for growth has received generous support from philanthropic individuals and foundations, including a $60 million lead investment by Blue Meridian Partners. Our unique approach has been featured in The New York Times, Washington Post, the Atlantic, CNN, Vox, and Marie Claire. 

Following our first statewide intervention in Delaware, a leading national research center estimates a 24% decrease in unplanned pregnancies among Title X patients between 2014 and 2017. Patient surveys conducted at our partner healthcare centers affirm that Upstream-trained providers are empowering patients to make their own decisions about their contraceptive care.

Upstream USA

Career Level:&nbsp;Mid Career&nbsp;
Salary Grade: 8 or 9 (see hiring range)
Travel: up to 25%
Organizational Summary
Upstream USA is a fast-growing, national nonprofit committed to ensuring that equitable, patient-centered contraceptive care is made available to any patient and is fully integrated into the health system as part of basic health care. We envision a future where all patients are screened for their contraceptive needs and offered patient-centered contraceptive counseling that’s free from bias, noncoercive, trauma-informed and delivered by knowledgeable providers and support staff following best medical practices and evidence-based guidelines. We believe all patients should be able to access the contraceptive service of their choice – when they want it and where it is convenient for them to get it.
We do this by partnering with healthcare organizations, providing them free training, education and technical assistance. Surveys from patients receiving care at Upstream-trained healthcare organizations consistently show that patients feel heard and respected, and are able to access the contraceptive method of their choice.
To meet the growing needs in our country, Upstream has launched a national expansion to transform contraceptive care in more than 700 healthcare organizations across the United States by 2030, reaching 5 million patients of reproductive age. Already, our work with more than 130 healthcare partners in nearly forty percent of the country helps integrate much needed contraceptive services across the spectrum of healthcare, including primary care practices.
Upstream is funded primarily through philanthropic individuals and foundations, and does not accept funding from pharmaceutical companies. Upstream’s budget has grown from $1.7 million just six years ago to approximately $60 million in 2024. Upstream’s work has also garnered attention from many leading publications including <a href="https://harvardpublichealth.org/policy-practice/how-upstream-usa-helps-increase-access-to-birth-control/">Harvard Public Health</a><a href="https://www.bloomberg.com/news/articles/2023-06-23/biden-orders-us-agencies-to-make-contraception-more-accessible">,</a><a href="https://www.bloomberg.com/news/articles/2023-06-23/biden-orders-us-agencies-to-make-contraception-more-accessible"> </a><a href="https://www.bloomberg.com/news/articles/2023-06-23/biden-orders-us-agencies-to-make-contraception-more-accessible">&nbsp;Bloomberg,</a> <a href="https://www.medpagetoday.com/opinion/second-opinions/106718?trw=no">MedPage Today,</a> and <a href="https://www.politico.com/news/magazine/2022/05/12/contraception-clinic-texas-roe-wade-family-planning-00031054">Politico</a>.
Position Summary
The Practice Transformation Lead (PTL) drives the implementation of Upstream’s technical assistance and contraceptive care practice change with partnering health care organizations (HCOs). The PTL leads the partnership engagement and manages the overall project and relationships for Upstream, coordinating with the multidisciplinary Upstream staff assigned to the HCO. The PTL will ensure that health center locations have the best-known practice guidance, resources, and tools necessary to meet the goal of providing equitable and patient-centered access to all contraceptive methods.
Essential Duties and Responsibilities
Serve as an advisor and project facilitator to partner HCOs, evaluating each of its health center sites for readiness and gaps to providing patient-centered access to all methods of contraception in primary care, family planning clinics and outpatient and inpatient (labor and delivery) settings. Practice Transformation Leads provide a range of technical and administrative services at increasing levels of complexity to support practice transformation. Individuals within these positions are expected to demonstrate this skillset with an increasing level of proficiency.
Key responsibilities include:
<ul>
<li>Establish trust and rapport with HCO and site leadership in an effort to gain positive momentum and engagement from key supporters in the contraceptive access practice transformation work.</li>
<li>Conduct assessment for the HCO, including interviews with key HCO and site-level administrative and clinical leadership and staff.</li>
<li>Develop analyses and present recommendations to facilitate decision-making discussions on contraceptive access policy, protocols, and related processes resulting in a high-level implementation plan.</li>
<li>Evaluate current workflow at each site to identify bottlenecks and potential improvements to contraceptive care delivery.</li>
<li>Develop and maintain HCO and site specific implementation work plans that outline key milestones. Continuously monitor progress with HCO leadership, as well as Upstream leadership.</li>
<li>Assess, recommend, and facilitate service improvements related to contraceptive care such as:
<ul>
<li>Integrating reproductive health screening questions into the electronic health record, including providing template samples and recommendations for best known practices related to documentation and workflow.</li>
<li>Provide guidance for how to offer access to patient assistance programs to cover the cost of contraception.</li>
<li>Provide guidance for creating or adjusting contraceptive care protocols, policy procedures, and consent forms.</li>
<li>Provide workflow guidance (or utilize other healthcare consultants) to ensure routine screening for contraceptive need, provision of patient-centered counseling, and same day access to all methods of contraception.</li>
<li>Assistance with stocking contraceptive and emergency contraceptive options, including integrating non-hormonal IUD as emergency contraception on-demand, same day.</li>
<li>Assistance with utilizing all levels of clinical and support staff to efficiently streamline contraceptive care for in-person and telehealth visits.</li>
<li>Provide support on billing and coding to ensure maximum reimbursement for contraceptive services.</li>
<li>Identify and recommend other technical assistance as needed.</li>
</ul>
</li>
<li>Assess defined measures for quality improvement and, as needed, partner with HCO leadership to test additional improvement opportunities.</li>
<li>Work with Upstream training team to ensure HCO receives comprehensive training package, including:
<ul>
<li>Upstream Core Training for all relevant HCO staff;</li>
<li>Clinical practicum for providers identified as needing training on IUD placement and removal services;</li>
<li>Focused training for identified Site Champions to support on-the-ground coaching and skills adoption for support staff.</li>
</ul>
</li>
<li>Monitor dashboards with Upstream Monitoring, Evaluation, and Learning (MEL) team to track progress in integration of contraceptive care workflows and access to contraceptive methods, including monitoring success of training and precepting new provider learners in IUD/Implant placement and removal.</li>
<li>Work with sites to complete their post-training precepting plans, including making best known practice recommendations regarding provider mentoring, scheduling, and increasing/balancing patient demand.</li>
<li>The Practice Transformation Lead supports data connectivity and electronic health record (EHR) integration activities as follows:
<ul>
<li>Identifying and coordinating with HCO contacts involved with EHR integration via Upstream’s 3rd party data collection vendor.</li>
<li>Support HCO integration of reproductive health screening questionnaire, contraceptive counseling and end method documentation in EHR.</li>
<li>Collaborate with the MEL team and EHR Integration Specialist in receiving information from the HCO.</li>
<li>Facilitate and support ongoing data hygiene.</li>
</ul>
</li>
<li>Additional duties as assigned.</li>
</ul>
Required Education, Experience, Knowledge, Skills and Ability
Upstream celebrates and fosters an inclusive work environment and encourages people of all identities, perspectives and backgrounds to apply.
<ul>
<li>5 or more years experience working in a health care environment and thorough understanding of the challenges of working in healthcare and reproductive health, or equivalent combination of professional experience and education.</li>
<li>Knowledge of healthcare process improvement and practice facilitation to build capacity for continuous improvements.</li>
<li>Knowledge of and experience in successfully implementing a framework for change management.</li>
<li>Established experience managing projects across multiple functions and levels (from direct reports to peers to executives).</li>
<li>Solid understanding of best known practices related to same-day access to contraceptive care.</li>
<li>Experience leading/facilitating teams to achieve goals and realize impact.</li>
<li>Excellent written and verbal communication skills; communicates articulately and confidently under all circumstances; establishes rapport quickly with all levels of staff.</li>
<li>Demonstrated ability to work and collaborate across multiple organizational functions and areas; ability to collaborate, communicate, influence and work effectively with diverse staff.</li>
<li>High level of proficiency and solid understanding of G-suite, Microsoft Word, Excel, and PowerPoint, quick learner of new software/programs.</li>
<li>Ability to travel up to 25% to provide on-site technical assistance to HCO partners and for other team and organization teaming events and trainings.</li>
<li>Upstream USA’s COVID-19 Vaccine Policy requires employees to have completed a COVID-19 vaccine primary series unless a medical or religious exemption is approved. As a condition of employment, newly hired employees must provide proof of their COVID-19 vaccination or, if applicable, request a medical or religious exemption.</li>
<li>All Upstreamers must also be able to attend work-related in-person meetings and functions as needed.</li>
<li>In our hybrid work environments, there is a basic expectation that our Upstreamers will ensure that their work from home setups will have reliable access to phone and Internet to ensure connectivity to their teams.</li>
<li>At Upstream we gather for moments that matter for training, teaming and connection. Our teams come together for occasional in person meetings and organizational retreats. As part of our hybrid work practices, this travel expectation will be applicable for all Upstreamers, even those based remotely.</li>
<li>Engage in EDI learning &amp; development, community engagement, and culture building activities up to 5% FTE (i.e., 2 work hours per 40 hour work week). Examples include attending trainings, conferences and summits, volunteering time, participating in local community events, mentoring and learning, participating in Communities of Belonging or Culture Council, developing language acquisition, learning universal design principles, and using professional development benefits for EDI topics, among other activities.</li>
</ul>
&nbsp;Non-Essential Education, Experience, Knowledge, Skills and Ability
<ul>
<li>Master’s or Bachelors in Public Health or Healthcare Administration, or related field.</li>
<li>Knowledge of quality improvement methodologies and PDSA cycles.</li>
</ul>
Attributes
The ideal candidate will embody and embrace our core values which serve as our operating principles:
<ul>
<li>We keep our mission at the center;Upstream's mission is to ensure that equitable, patient-centered contraceptive care is basic healthcare&nbsp;</li>
<li>We trust each other; we are reliable, empathetic, compassionately direct, and confident in each others’ ability to do the same</li>
<li>We work every day to build an equitable, diverse and inclusive culture; we respect the backgrounds contexts and experiences of individuals, teams and partners in our interactions</li>
<li>We bring joy to our work; we create opportunities to celebrate, connect and strengthen relationships with one another.</li>
</ul>
Additional Attributes
<ul>
<li>Top-notch internal and external customer service at all times, including prompt, professional, high quality verbal and written communications.</li>
<li>Ability to effectively lead multiple projects simultaneously and prioritize accordingly.</li>
<li>Ability to understand and communicate concepts quickly and accurately.</li>
<li>Natural leader who organizes and inspires others to achieve goals.</li>
<li>Well organized with a detail orientation, analytical, confident and proactive self-starter who is skilled in taking initiative and working well independently.</li>
<li>Demonstrated follow-through – meets stated project expectations – on-time and with quality</li>
<li>Demonstrates a high degree of adaptability, comfortable in establishing new direction, and navigating rapid change.</li>
<li>Possesses excellent interpersonal skills. Builds and maintains positive, productive relationships with colleagues, staff, consultants, and clients within a hybrid work environment of virtual and in-person settings.</li>
<li>Thrives in an environment of continuous feedback and is skilled at both giving and receiving feedback in a timely manner.</li>
<li>Solid work ethic and a team oriented attitude.</li>
<li>Sense of humor.</li>
</ul>
Travel Requirements
This role will require up to 25 % of business travel. All Upstreamers can expect a minimum of 8 days of business travel per year to attend 1-2 annual organizational retreats and two annual team/department meetings.
Upstream Benefits
Upstream USA offers a comprehensive benefit package including medical, dental, vision, life insurance, long and short term disability, 401K with a match, generous vacation, personal, sick and holiday time off, parental leave, professional development, a fitness and cell phone allowance for all full time employees and part time employees who work a minimum of 24 hours per week. &nbsp;
Hiring Range
The hiring range for our Practice Transformation Lead roles is $94,400 to $125,000.&nbsp; The Practice Transformation Lead position has two different career levels at Upstream. Career level placement and final offers for this position will be based upon several factors including the scope of the candidate’s experience and competencies, the market compensation analysis, the position level requirements,&nbsp; internal pay equity consideration and will be made within the parameters of Upstream USA's compensation framework and philosophy. The position levels and hiring ranges will be discussed during your interview.&nbsp; Our Practice Transformation II role requires demonstratable subject matter expertise in primary care and sexual and reproductive health coupled with strong relationship development and management skills.
The Practice Transformation Lead I typical hiring range is a minimum of $94,400 and a maximum of $110,000. The Practice Transformation Lead II typical hiring range is a minimum of $115,000 and a maximum of $125,000.
Hiring Process
Candidates who advance in our preliminary review process will have an opportunity to discuss the position, their employment background and lived experience with a member of our talent acquisition team by telephone. Those who advance to subsequent steps in our interview process may participate in up to three rounds of meetings by Zoom or in person and in a thought exercise/case study assignment. Each round could consist of multiple meetings with various Upstreamers.
EDI Vision Statement
&nbsp;Internally, we envision promoting equity by reducing disparities in the Upstream talent lifecycle and engagement, cultivating a diverse workforce and inclusive culture, and fostering power sharing when we make decisions.
EDI Guiding Principles
Through Equity, both in the workplace and in contraceptive care, we address root causes that enable disparities to occur, acknowledge that different resources and opportunities may be needed to reach fairer outcomes, and implement systems-level changes that are sustainable over time.
Through&nbsp;Diversity, we acknowledge, respect, and celebrate the collective mixture of differences and similarities of Upstreamers and our community partners. At Upstream, we value the diversity of identities at all intersections, while at the same time centering racial diversity.
Through&nbsp;Inclusion, we succeed at creating a culture of belonging that embraces differences in identities and experiences by building trust, joy, and psychological safety. We cherish and elevate these differences through power-sharing in how things get done internally and in service of our mission.
Communities of Belonging
Serving as employee resource groups for Upstreamers, Communities of Belonging assist in advancing our equity, diversity, and inclusion journey. They assist in instilling organizational values in our work and support our EDI vision. Open to all employees, Communities of Belonging create opportunities for leadership development, community engagement, support, and resource mobilization.
Upstream Careers
At Upstream, we embrace diversity. We nurture it and we thrive on it because it benefits our organization, our partners, and our community. Our goal is to attract, develop and retain exceptional people, and to create a work environment that is dynamic, rewarding and enables each of us to realize our potential.&nbsp; Upstream is committed to equal employment opportunity regardless of race, color, ancestry, religion, sex, national origin, sexual orientation, age, citizenship, marital status, disability, genetic information, gender identity or Veteran status. We also consider qualified applicants regardless of criminal histories, consistent with legal requirements. If you have a disability or special need that requires accommodation, please let us know.<a href="https://upstream.org/diversity-equity-inclusion/"> </a><a href="https://upstream.org/diversity-equity-inclusion/">Learn more</a>&nbsp; about<a href="https://www.upstream.org/careers/"> </a><a href="https://www.upstream.org/careers/">working at Upstream</a>,<a href="https://www.upstream.org/our-culture/"> </a><a href="https://www.upstream.org/our-culture/">our values</a>, and our commitment to <a href="https://upstream.org/diversity-equity-inclusion/">Equity, Diversity and Inclusion</a>. Upstream USA participates in E-Verify.
Upstream Headquarters
2 Oliver Street, Suite 402, Boston, MA 02109
<a href="http://www.upstream.org">www.upstream.org</a>
No phone calls please.
Be advised that we do not ever conduct hiring interviews via text or email.&nbsp;<a href="https://upstream.org/hiring-fraud/">Please protect yourself by learning more about our hiring practices and common red flags to look out for.</a>