Practice Transformation Lead - Reproductive Healthcare (remotely based Southeast)

Career Stage: Manager

Organization 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 program in Delaware in 2014, we have partnered with health centers in Washington state, Massachusetts, North Carolina, Rhode Island, Texas, Mississippi and Missouri. By 2023, Upstream will have partnered with health centers that serve over one million women of reproductive age annually across these states and more.

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 four years ago to approximately $42 million in 2022. 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.

Position Summary

The Practice Transformation Lead (PTL) drives the implementation of Upstream’s technical assistance and contraceptive care practice change with partnering health care agencies. The PTL leads the partnership engagement and manages the overall project and relationships for Upstream, coordinating with a team of Upstream Practice Transformation staff assigned to the health center. The PTL will ensure that health center locations have the best-known practice guidance, resources, and tools necessary to meet the goal of reducing unplanned  pregnancy by providing same-day access to all contraceptive methods.

Essential Duties and Responsibilities

Serve as an advisor to partner agencies, evaluating each of its health center sites for readiness and gaps to providing same day access to all methods of contraception in primary care, family planning clinics and outpatient and inpatient (labor and delivery) settings.

Key responsibilities include:

  • Establish trust and rapport with agency and site leadership in an effort to gain positive momentum and investment from key supporters in the Upstream program.
  • Conduct assessment for the agency, including interviews with key agency and site-level administrative and clinical leadership and staff.
  • 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.
  • Evaluate current workflow at each site to identify bottlenecks and potential improvements to contraceptive care delivery.
  • Develop and maintain agency and site specific implementation work plans that outline key milestones. Continuously monitor progress with agency leadership, as well as Upstream leadership.
  • Assess, recommend, and facilitate service improvements related to contraceptive care such as:
    • Integrating pregnancy intention questions into the electronic health record, including providing template samples and recommendations for best known practices related to documentation and workflow.
    • Provide guidance for how to offer access to patient assistance programs to cover the cost of contraception.
    • Provide guidance for creating or adjusting contraceptive care protocols, policy procedures, and consent forms.
    • Provide workflow guidance (or utilize other healthcare consultants) to ensure same day access to all methods of contraception.
    • Assistance with stocking contraceptive and emergency contraceptive options, including integrating non-hormonal IUD as emergency contraception on-demand, same day.
    • Assistance with utilizing all levels of clinical and support staff to efficiently streamline contraceptive care for in-person and telehealth visits.
    • Provide support on billing and coding to ensure maximum reimbursement for contraceptive services.
    • Identify and recommend other technical assistance as needed.
  • Assess defined measures for quality improvement and, as needed, partner with agency leadership to test additional improvement opportunities.
  • Work with Upstream training team to ensure agency receives comprehensive training package, including:
    • Focused training for identified Site Champions to support on-the-ground coaching and skills adoption.
    • Upstream Core Training for all relevant agency staff.
    • Clinical practicum for providers identified as needing training on IUD placement and removal services.
  • Monitor dashboards with Upstream Monitoring, Evaluation, and Learning team, to track progress in regards to precepting IUD/Implant placement with providers.
  • 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.
  • The Practice Transformation Lead supports data connectivity and electronic health record (EHR) integration activities as follows:
    • Identifying and coordinating with agency contacts involved with EHR integration via Upstream’s 3rd party data collection vendor.
    • Support agency integration of pregnancy intention screening questionnaire, contraceptive counseling and end method documentation in EHR.
    • Collaborate with the monitoring, evaluation, learning (MEL) team and EHR Integration Specialist in receiving information from the agency.
    • Facilitate and support ongoing data hygiene.

Required Education, Experience, Knowledge, Skills and Ability

  • 5-10 years experience working in a health care environment and understanding of the challenges of working in healthcare and reproductive health, or equivalent combination of professional experience and education.
  • Knowledge of healthcare process improvement and practice facilitation to build capacity for continuous improvements.
  • Knowledge of and experience in successfully implementing a framework for change management.
  • Established experience managing projects across multiple functions and levels (from direct reports to peers to executives).
  • Solid understanding of best known practices related to same-day access to contraceptive care.
  • Experience leading/facilitating teams to achieve goals and realize impact.
  • Excellent written and verbal communication skills; communicates articulately and confidently under all circumstances; establishes rapport quickly with all levels of staff.
  • Demonstrated ability to work and collaborate across multiple organizational functions and areas; ability to collaborate, communicate, influence and work effectively with diverse staff.
  • High level of proficiency and solid understanding of G-suite, Microsoft Word, Excel, and PowerPoint, quick learner of new software/programs.
  • Ability to travel up to twice per month, across Upstream state projects, to provide on-site technical assistance to healthcare partners.
  • Able to attend work related in-person meetings and functions as needed. (Upstream employees are required to be fully vaccinated to attend in-person work-related activities. Reasonable accommodations will be made for individuals with a sincerely held religious belief or disability who are not vaccinated.)
  • 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.
  • 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.   

Non-Essential Education, Experience, Knowledge, Skills and Ability

  • Master’s or Bachelors in Public Health or Healthcare Administration, or related field.
  • Knowledge of quality improvement methodologies and PDSA cycles.   


  • Top-notch internal and external customer service at all times, including prompt, professional, high quality verbal and written communications
  • Ability to effectively lead multiple projects simultaneously and prioritize accordingly
  • Ability to understand and communicate concepts quickly and accurately
  • Natural leader who organizes and inspires others to achieve goals
  • Well organized with a detail orientation, analytical, confident and proactive self-starter who is skilled in taking initiative and working well independently
  • Demonstrated follow-through – meets stated project expectations – on-time and with quality
  • Demonstrates a high degree of adaptability, comfortable in establishing new direction, and navigating rapid change
  • Possesses excellent interpersonal skills. Builds and maintains positive, productive relationships with colleagues, staff, consultants, and clients
  • Thrives in an environment of continuous feedback and is skilled at both giving and receiving feedback in a timely manner
  • Solid work ethic and a team oriented attitude
  • Sense of humor

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 and a fitness and cell phone allowance for all full time employees and part time employees who work a minimum of 24 hours per week.

Hiring  Range

The hiring range for this role is $82,795.79 to $100,000  Final offers for this position will be based upon several factors including the scope of the role, market compensation analysis, position requirements, candidate’s experience level and capabilities, specific candidate geographic location, internal pay equity considerations and will be made within the parameters of Upstream USA's compensation framework and philosophy.

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 Upstreamour values, and our commitment to Diversity, Equity and Inclusion. Upstream USA is an E-Verify employer.

Upstream Headquarters

2 Oliver Street, Suite 402, Boston, MA 02109

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