This article examines how the Post-NPM administrative model adopted by a teaching hospital in Portugal shapes innovation processes. We find that innovation is a multi-level organizational phenomenon which relies substantially on the interplay of three factors: (1) trust-based professional autonomy at the individual level, (2) an intra-organizational collaborative approach in innovation (re-)design at team level, and (3) staff involvement/commitment towards the hospital’s strategy in the implementation of innovations at the organizational level. Additionally, innovation is facilitated by interconnected formal and informal processes that mutually reinforce each other. The study contributes to the literature on innovation and administrative models by providing a nuanced understanding of how intra-organizational innovation processes take place within a Post-NPM model. As such, it is one of the first attempts to empirically analyze and link the administrative model of Post-NPM with innovation.