A physician who contracts with or is employed by a health care plan (or other managed care organization) to provide medical direction. Responsibilities will include review of authorizations for referrals and admissions, review of cases for quality and utilization issues, formulation of clinical policies, criteria, and standards, and so forth.
A physician, usually employed by the hospital, who serves as the administrative head of the medical staff. “Medical director” tends to be the title for the chief of staff when that person is a paid hospital employee. The title may also be “vice president for medical affairs” or something similar. This term is discussed further under chief of staff.