Executive Director - Rhode Island

Organizational Summary

Upstream USA is a fast-growing, national nonprofit working to expand opportunity by reducing unplanned pregnancy across the U.S. Upstream partners with states to provide training and technical assistance to health centers, increasing equitable access to the full range of contraceptive options. Our transformative approach empowers patients to decide when and if they want to become pregnant, a critical step towards improving outcomes for parents and children.

Upstream is growing rapidly and is on track to achieve nationwide impact. After launching our first statewide initiative in Delaware in 2014, we have since launched projects in Washington state, Massachusetts, and North Carolina. By 2023, Upstream will have partnered with health centers that serve over one million women of reproductive age annually across these states.

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 three years ago to approximately $25 million in 2019. Upstream’s work has also garnered attention from many leading publications including The New York Times, Washington Post, The Atlantic, CNN, Vox, Forbes, and Marie Claire.

Upstream is growing rapidly and is on track to achieve nationwide impact. After launching our first statewide initiative in Delaware in 2014, we have since launched projects in Washington state, Massachusetts, and North Carolina. Governor Raimondo’s administration is launching a statewide effort to improve contraceptive access, and has chosen Upstream as the technical partner. By 2023 Upstream will have partnered with health centers that serve over one million women of reproductive age annually across these five states.  Upstream’s budget has grown from $1.7 million just three years ago to approximately $48 million in 2020.

We are seeking an entrepreneurial, impact-oriented Executive Director to launch and lead a multi-year initiative to reshape reproductive health care in Rhode Island. This position is not a fundraising position; Upstream’s national team is responsible for securing and stewarding financial support for the work in Rhode Island. 


Nearly half of all pregnancies in the United States are unplanned, resulting in 1.5 million births each year. In Rhode Island, 40% of pregnancies were unplanned in 2014. Nationwide data show that close to half of unplanned pregnancies occur to women who are using contraception, but the method they are using does not work well for them. 

While Rhode Island has a strong policy environment related to contraceptive services and access, many health centers are not equipped to offer women the full range of contraceptive options. Upstream plans to partner with all health centers offering primary care in the state, as well as the main hospital systems in the labor and delivery setting, to ensure that all patients can easily access the full range of contraceptive methods on the same day of their visit at low or no cost. When individuals are able to achieve their own goals of becoming pregnant only if and when they want to, there is an extraordinary opportunity to improve outcomes for women, children and their families.  

Early results demonstrate that Upstream, in partnership with health centers and hospitals, can have a significant impact on improving contraceptive care. 99% of patients surveyed report they are in charge of choosing the contraceptive method that is best for them, that they did not feel pressured to choose any method of birth control, and they felt listened to during their contraceptive visit. A 2018 report by Child Trends, a leading national research center, estimated a 24% decrease in unplanned pregnancies among Title X patients between 2014 and 2017, compared with a 3 percent decrease nationwide during the same period.

Position Summary 

Upstream seeks an entrepreneurial, experienced leader to launch and lead Upstream’s Rhode Island expansion, a multi-year initiative to improve access to contraception across Rhode Island. The Executive Director will be Upstream's first hire in Rhode Island and will build and manage the state work from the ground up—building the team, managing the budget, and stewarding key relationships with health center and state leadership to ensure the long-term sustainability of Upstream’s work.

A successful candidate will have leadership experience building and recruiting an energized and committed team in an atmosphere of rapid organizational growth. S/he will have a strong action bias, the innovative spirit of an entrepreneur who thrives on building and growing an organization, and an ingrained focus on impact. Upstream’s national team secures all financial resources, so this position does not require fundraising experience. The Executive Director of Upstream Rhode Island will work with colleagues both in Rhode Island and across the organization.

While this is a time-limited position anticipated through at least Q4 2022, there may be future opportunities within Upstream.

Specific responsibilities include, but are not limited to:

Regional Leadership

  • Create and lead the implementation of a comprehensive project in Rhode Island between 2020-2023
  • Build a high-performing team of 10-15 FTEs in Rhode Island
  • Manage all aspects of the implementation of Upstream's proven program in Rhode Island 

Relationship Development and Engagement

  • Engage and develop relationships with key health systems in Rhode Island and other key stakeholders (the Governor’s Office, health care, community, and advocacy leaders) to effectively deliver Upstream's training and technical assistance within the local context
  • Work closely with the Executive Office of Health and Human Services and related agencies to lead a statewide effort to improve contraceptive access in Rhode Island, including promoting contraceptive access policy changes, building momentum with key healthcare leaders, and cementing the long-term sustainability of Upstream’s systemic change
  • Oversee a team that will recruit and partner with health centers, hospitals, and other healthcare facilities to receive Upstream's technical assistance intervention
  • Recruit and manage a team of clinical and support staff trainers and quality improvement officers who perform the client-facing work
  • Work with Upstream's national team to ensure that implementation is aligned with the organization's best practices 

Program and Operational Management

  • Maintain a breadth of knowledge about current healthcare trends in the region, emerging issues, policy, and innovations that might impact Upstream's work
  • Provide oversight for the initiative's finances, manage an annual budget, and ensure strategic allocation of resources
  • Lead all day-to-day operations of Upstream's work in the region
  • Identify office space and manage all start-up operations for a new and growing team
  • Oversee research and gather information important to planning the rollout of Upstream's intervention, including the number of health centers to be trained, the number of women to be served by the health centers, number of clinicians to be reached, etc. 


  • A minimum of 10 years of professional experience, including building and managing a team in a rapidly growing organization
  • Exceptional organizational leadership skills, with demonstrated success leading and managing an organization through the start-up and early growth phase
  • Entrepreneurial spirit and the natural inclination to take initiative, move quickly, and be creative
  • Comfort working independently. As the first hire in Rhode Island, a high degree of flexibility and entrepreneurism will be needed to navigate the change and ambiguity inherent in launching this new initiative
  • Excellent interpersonal skills, with the ability to develop productive working relationships across a diverse spectrum of stakeholders (internal and external), exhibit sensitivity, and appreciate cultural differences
  • Experience developing and overseeing budgets, with the capacity to allocate resources strategically and manage spending against the budget
  • Strong project management skills, with experience directing and coordinating the work of others
  • Facilitative and collaborative work style, with the ability to build bridges across divergent and competing interests
  • Commitment to Upstream's mission; determination to overcome obstacles and find alternative ways to pursue goals
  • Personal commitment to expanding opportunity, recognizing that Upstream’s work to reduce unintended pregnancy is grounded in addressing the inequities and bias in our health care system, particularly for low-income individuals and people of color
  • Knowledge of local Rhode Island context 

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 creating a work environment that is dynamic, rewarding and enables each of us to realize our potential.  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. Learn more  about working at Upstream, our values, and our commitment to Diversity, Equity and Inclusion.  Upstream is an E-Verify employer.

Upstream Headquarters: 426 17th St, Suite #200, Oakland, CA 94612





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