How to “Manage Up” in Physician Compensation Projects (and actually get leadership buy-in)

In regulated industries like healthcare, physician compensation project management goes well beyond tracking tasks and managing resources (think, ever-evolving set of financial models and clinical goals). These programs impact value-based care incentives, morale, retention, patient care, and the bottom line. Which is why managing your team is only half the job.

A physician compensation initiative is often held together by a project manager who manages timelines, teams, complex compliance requirements, and (often) an organization’s collective sanity. 

To truly lead physician compensation projects to success, project managers need to “manage up”—proactively engaging senior leaders and physician stakeholders to ensure alignment, buy-in, and long-term sustainability. 

Here’s how you can manage up effectively and keep your physician comp initiatives from becoming another spreadsheet lost in the shuffle.

5 ways to manage up in Physician Compensation initiatives and drive success

1. Communicate early, often, and intelligently.

Comp programs are emotionally and politically charged. Physicians are understandably sensitive to changes, and executives are under pressure to balance budgets and demonstrate ROI. The last thing you want is a leader learning about a delay or error in a room full of peers or physicians.

Managing up means making sure key stakeholders (especially senior leadership) are aware of updates before they become issues—ideally, when they’re not holding a hot drink they can throw on you.

For example:

• Let your CMO or CFO know of any modeling delays or potential pushback before it lands in a committee meeting.
• Loop in legal and compliance leads early if you’re navigating Stark Law or fair market value(FMV) healthcare concerns.
• Prep your leadership team with talking points when communicating comp changes to department heads or physicians.
• If there’s a big surprise coming, handle it in a one-on-one conversation rather than letting it unfold in a crowded room. It might take extra time upfront, but it saves you from potential headaches later on. 

2. Build a strong cross-functional communication framework

A physician comp program isn’t owned by one team. It sits at the intersection of clinical operations, finance, HR, legal, and IT. Your communication strategy should reflect that. Each of these areas has its own priorities and pain points, and as the person responsible for physicians’ compensation, you need to anticipate these and address them proactively. 

A strong communication framework should include:

• Regular and concise meeting notes sent to all involved departments.
• Setting up recurring check-ins.
• Weekly or biweekly updates to executives: with key milestones, red flags, and upcoming decisions.
• One-pagers or dashboards highlighting key changes to comp models or payout schedules.
• Structured input sessions with physician liaisons or department chairs to ensure feedback is heard early—not after implementation.
• A designated “escalation protocol” for when physician concerns or leader objections need fast resolution.

When each department knows where things stand and what’s expected of them, you’re not just managing a project—you’re orchestrating an enterprise-level shift.

“No project manager wants to hear ‘We need to talk’ from their leadership—it’s as terrifying as hearing it from a spouse! Keep those updates flowing, so your key stakeholders don’t get blindsided in meetings.”

Tom Waddell

3. Present challenges with solutions (not just problems) if you want to “Manage Up” in Physician Compensation Projects (and actually get leadership buy-in)

As cliched as that sounds, there’s a reason why ‘come with solutions, not problems’ is still a popular adage. No comp initiative runs without friction. Maybe a new incentive metric is underperforming. Or a data integration with your EHR vendor is delayed. Whatever the issue, do NOT show up empty-handed. 

If you have a problem or bad news, don’t just deliver it cold. When managing up:

• Provide clear context(what’s happening and why).
• Explain the impact(how it affects physicians, operations, or payouts).
• Offer a plan(updated timelines, alternative structures, etc.) .

Remember Coach from Cheers? Every time he had to deliver bad news, he softened it by sharing something even worse first. While that technique doesn’t quite fly here(even though it’s funny), you can still soften the blow. For example, if legal review delays a comp model launch, offer a revised timeline and an interim communication plan.

This approach reassures leadership that you’re managing risk, not just reacting to it. It demonstrates critical thinking and positions you as a proactive problem-solver. 

At Waddell Group, our project managers bring more than checklists—they bring strategy, foresight, and a calm, consistent presence in high-stakes environments. Whether you are optimizing credentialing processes, integrating new acquisitions, or improving onboarding and staffing workflows, we bring proven strategies and hands-on leadership to get results. Here’s how we do that.

4. Build trust with key stakeholders to manage up successfully

You don’t want your first meaningful conversation with a senior executive to happen after a physician comp issue blows up. Start cultivating those relationships early. That might look like:

• Periodic informal updates or coffee chats with your sponsor.
• Offering to prep execs before physician board meetings or public presentations.
• Showing interest in their strategic goals, so you can position the comp program accordingly.

Communicate with your stakeholders (as much as works for both of you) when there isn’t an issue to solve or decisions to make. If you only have interactions with them formally, it’s likely a pretty shallow relationship. Find some similar interests, do something for them they don’t like to do, let them know a bit about you. It will make a difference during stressful times if you have some common ground.  

When executives know you, trust you, and see you as someone who “gets it,” they’re far more likely to champion your project, provide cover when things go sideways, and advocate for your needs.

When there is more formal business to be solved, prepare for the conversations wisely.

1. Prepare a solid argument for what you need: Before you approach leadership, have your reasoning laid out clearly. Be logical and back your request with evidence or data, making it easy for them to understand why it’s important.
2. Make the ask clear and direct: Be specific about what you need. Whether it’s support from another department or additional resources, clearly state what action you want them to take.
3. Show appreciation: Acknowledge their support when they help you or your project. A simple thank you goes a long way.

A solid working relationship with your stakeholders can make all the difference when you need support on your project. But this isn’t about sucking up to them. And it’s definitely not about manipulating them into liking you so that they do you favors. It’s about connecting with them on a human level, understanding their motivations and creating trust.

“If you can make your boss laugh or at least nod in agreement, you’re halfway there. After all, managing up isn’t just about keeping them informed—it’s about showing them how your work makes their life easier.”

Tom Waddell

5. Align with leadership priorities

To manage up effectively, know what drives the executives you communicate with and manage. Is it career growth? Company success? Team recognition? Maybe the COO cares about throughput, the CMO about outcomes, and the CFO about sustainable cost modeling. Communicate how your  your comp project checks their boxes:

• Is it driving physician alignment with value-based care initiatives?
• Is it helping with recruitment or retention goals?
• Is it producing measurable ROI on payer contracts?

Build a rapport. This approach makes it easier to get buy-in, even when you need something big. When your project’s outcomes directly contribute to leadership and stakeholder goals, they’re more likely to provide additional support and resources.

And remember, this isn’t a manipulation tactic either. It’s about aligning your comp project with their vision, showing that you’re both working toward a shared goal. 

Managing physician compensation projects requires more than a well-built Gantt chart. 

It demands emotional intelligence, strategic communication, and the ability to “manage up” with confidence and clarity.

It’s not about people-pleasing or politics. It’s about creating trust, preempting confusion, and aligning stakeholders around a shared goal: fair, compliant, effective physician pay programs.

At Waddell Group, our project managers bring more than checklists—they bring strategy, foresight, and a calm, consistent presence in high-stakes environments. Whether you are optimizing credentialing processes, integrating new acquisitions, or improving onboarding and staffing workflows, we bring proven strategies and hands-on leadership to get results.

Need help keeping your physician comp project on track and your execs aligned?