90% of tilted OWC cases I have seen have in fact been due to (a) compartmentalization or (b) capillary pressure changes due to (normally) changing perm across the field
If you actually DO have a tilted contact (requiring good perm AND a strong aquifer - you really cant have hydrodynamic OWC change without both), then the most robust way to initialize is to set highly productive constant head aquifers (honoring the change in head seen across the field) on either ends of your model and allow it to simulate for 500 years or so (however long is required to stabilize the contact) prior to putting any wells in there. I've only had cause to do this once - in a field in the PNG Highlands where a lot of data points to this sceanrio
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