Compensation Platform Modernization
Modernizing a legacy physician compensation program by reducing manual exceptions, increasing clinician transparency (including RVU/CPT visibility), and sequencing pilots (transparency → compensation) to regain momentum while standardizing pay models for scale.
Context
- Acquisition-driven complexity: the legacy system evolved to accommodate many local pay plans and pay-cycle cadences (weekly/biweekly/monthly), increasing complexity with each new site that didn’t fit a standard model.
- Operational drag: compensation relied on manual exceptions and “off-system” math, increasing rework and risk.
- Low transparency: clinicians had limited visibility into RVU / CPT-level inputs, which reduced trust and made resolution slower.
- Many upstream dependencies: the workflow touched timekeeping, HRIS, coding/RCM, billing, and payroll—so alignment across teams was essential.
Approach
- Governance at the right altitude: monthly executive SteerCo (business + clinical), weekly clinical SteerCo, and a daily core working group during sprints to keep decisions moving.
- Biweekly sprint cadence: iterative build/test cycles with clear owners, dated commitments, and explicit dependency tracking in Smartsheet and ServiceNow.
- Pilots as a product loop: structured rollout as staged pilots to gather clinician feedback early, resolve usability gaps, and validate data/logic before cutover.
- Change management as a deliverable: direct engagement with clinicians and site leaders; real-time support during pilot windows; feedback captured via structured forms.
- Dependency management: partnered closely with the compensation simplification workstream so plan standardization and system automation stayed in lockstep.
I optimized for “make the next decision easier” because that’s what keeps cross-functional programs from stalling.
Decision snapshots
Sequence delivery: RVU first to restore momentum
Problem: early discovery showed hourly compensation logic was more complex than expected, increasing risk to timelines and trust.
Move: validated current-state complexity with Compensation, Contracting, and HRIS; mapped incremental build effort with the vendor; then pivoted delivery sequencing to prioritize RVU workflows first.
Result: enabled earlier clinician access via an RVU transparency pilot (late 2025 / early 2026) while hourly requirements were re-scoped.
Pilot design: transparency → compensation (run in parallel)
Decision: structure pilots in two phases—first to validate visibility and usability, then to validate compensation calculations—before a full cutover.
Tradeoffs: two pilots add coordination overhead, but reduce cutover risk and create cleaner feedback loops for clinicians and site leaders.
Result: Pilot 1 provided CPT/RVU visibility and a live feedback channel; Pilot 2 (compensation) runs calculations in-platform while continuing the legacy workflow in parallel for validation.
Make standardization a gating dependency
Problem: every non-standard pay plan increases exceptions and reduces the ability to scale automation across sites.
Move: partnered with compensation leadership and the parallel simplification PM to align plan design and system configuration as one integrated roadmap.
Result: reduced “one-off” configuration pressure and positioned the platform for expansion to additional sites/service lines.
Pilot feedback loop
The transparency pilot was designed as a fast feedback cycle: clinicians used the platform in real conditions, and we iterated quickly on the highest-friction issues.
- Search and filtering friction: while the platform provider works on improving search, I shipped an interim workflow that lets clinicians copy/paste their data into a lightweight spreadsheet for quick filtering and analysis.
- Self-serve data manipulation: packaged a simple export-and-analysis template so clinicians could answer common questions without waiting on support tickets.
- Clearer site labeling: added site names and standardized naming within two sprints to reduce ambiguity in multi-site views.
Outcomes
- Clinician transparency (in pilot): clinicians can see RVU / CPT-line detail as records pass coding QA—visibility that previously wasn’t available at scale.
- Adoption signals met: clinicians engaged actively in the transparency view, and pilot satisfaction was positive (qualitative + survey-based).
- Reduced manual exception pathways (expected): simplified, standardized compensation models are designed to cut down manual touches and rework as automation increases.
- Scalable support model (in progress): redesigned support paths and documentation aligned to the new platform to reduce “tribal knowledge” dependence.
Note: specific KPI values and internal system/vendor details are intentionally generalized.