Organizational Summary

Upstream is a rapidly growing national nonprofit working to expand economic opportunity and mobility by reducing unplanned pregnancy. Working in partnership with states, Upstream provides health centers of all types with sustainable training and technical assistance to ensure all women have access to the full range of contraceptive methods and are able to obtain the birth control method of their choice in a single visit with their health care provider at low or no cost.

Upstream is on track to achieve nationwide impact at scale. Our goal through 2023 is to partner with health centers that serve over 1 million women of reproductive age across four states. We launched our first state-based initiative in Delaware in 2014, followed by Massachusetts and Washington in 2017. North Carolina will be Upstream’s fourth state for expansion. Philanthropic individuals and foundations have provided generous support for this ambitious plan for growth, including a $60 million lead investment by Blue Meridian Partners, which has helped grow Upstream’s budget from $1.7 million just three years ago to approximately $25 million by 2019. Upstream’s work has also garnered attention from a variety of leading publications, including The New York Times, Washington Post, The Atlantic, CNN, Vox, Forbes,  and Marie Claire.

We’re now seeking an entrepreneurial, impact-oriented executive director to help lead a multi-year initiative to reshape reproductive health care for hundreds of thousands of women across North Carolina. This position is not a fundraising position. Upstream’s national team is responsible for securing and stewarding financial support for the work in North Carolina.


Nearly half of all pregnancies in United States are unplanned, resulting in 1.5 million births each year. In North Carolina, 54 percent of all pregnancies are unplanned. Data show that close to half of unplanned pregnancies occur to women who are using contraception, but the method failed them. Many health centers do not offer women the full range of contraceptive options, and as a result, unplanned pregnancy is unevenly distributed across the economic spectrum. The rate of unplanned pregnancy among low-income women is five times higher than that of higher-income women, which can perpetuate the cycle of poverty and economic inequality for women and their children.  

In North Carolina, we plan to partner with health centers of all types, as we have in other states, to ensure that women can easily access the full range of contraceptive methods on the same day of their visit at low or no cost. Our results demonstrate that Upstream can have a significant impact on reducing unplanned pregnancy in North Carolina. After Upstream implemented its approach statewide In Delaware, a 2018 report by Child Trends, a leading national research center, estimated a 15 percent decrease in unplanned pregnancies among Title X[1] patients between 2014 and 2016, compared with a 1.3 percent decrease nationwide during the same period. Upstream has also worked with individual health centers in Texas, Arizona, New York, Ohio, and Puerto Rico. 

When women are empowered to achieve their own goals of becoming pregnant only if and when they want to, there is an extraordinary opportunity to improve both short-term health outcomes and “downstream” outcomes related to education, economic mobility, and health.

Position Summary

Upstream seeks an entrepreneurial, self-motivated individual to launch, organize, and lead a statewide, multi-year initiative to improve access to contraception and reduce unplanned pregnancies across North Carolina. The Executive Director will be Upstream's first hire in North Carolina and will build, manage, and lead this initiative in the state from the ground up, including building the team, managing the budget, and recruiting health systems to participate in the intervention.  This position can be based in either Charlotte or the Raleigh/Durham area.

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. Reporting directly to Upstream's Co-CEO, the Executive Director of Upstream North Carolina will work with colleagues both in North Carolina and across the organization. Specific responsibilities include, but are not limited to:

Regional Leadership

  • Create and lead the implementation of a comprehensive project in North Carolina, a cornerstone of Upstream's strategic plan
  • Build a high-performing team hiring up to 60 FTEs in North Carolina over three years
  • Manage the implementation of Upstream's proven intervention

 Relationship Development and Engagement

  • Engage and develop relationships with a wide variety of health systems in North Carolina and other key stakeholders (government, health care, community, and advocacy leaders) to effectively deliver Upstream's training and intervention within the local context
  • Oversee a team that will recruit health centers, hospitals, and other health care 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 health care trends in the region, emerging issues, policy, and innovations that might impact Upstream's model
  • 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 North Carolina, 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
  • A keen intellect, with a strong work ethic and team player attitude
  • 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 the local North Carolina context strongly preferred

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 and 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.

Upstream Headquarters: 1630 San Pablo Ave., Suite 400, Oakland, CA 94612

[1] Title X is the Federal funding stream that pays for family planning services for low-income individuals. These patients are at very high risk for unplanned pregnancy.



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