A leading figure in the prepaid medical group pratice movement has rejected an offer by the Washington area's Group Health Association to become its new executive director because, he said, the group will not admit that it had "a problem."

The rejection by Dr. Ernest Saward of an offer by the governing board of GHA to become its top administrative officer underscores the rift that has developed between the board, elected by GHA's members, and the group's physicians.

GHA provides comprehensive health care for 108,000 members in the Washington area. The physicians employed by GHA, after trying unsuccessfully to gain a larger voice in the management of the organization, voted last January to form a union under the National Labor Relations Act.

The physicians currently are engaged in contract talks with representatives of GHA's board and have been conducing a "work-to-rule" action to protest the suspension of talks by the board.

GHA's current executive director, Louis J. Segadelli, has announced that he will leave in June. Segadelli supported a bid by the physicians last year to form a separate group and to contract with GHA for their service rather than continuing as employes. That proposal was rejected last spring by the board, which is elected by the plan's members.

Saward, now a professor of medicine at the University of Rochester and for 25 years the medical director of the Kaiser-Permanente medical plan in Oregon, is a highly respected figure in the prepaid group practice movement. His credentials as a physician with management experience appear to fit those described last year by GHA's president, Harold Wool, as what the board was seeking.

Saward said in an interview that after careful consideration he had decided to reject the offer. "They don't understand they have a problem," Saward said, "They're fine people, but they don't recognize what problems the independent members of the board are making."

Saward, echoing a criticism made by Segadelli, said that the board should limit itself out of day-to-day operations; until it does, they will not have a harmonious organization."

Wool said in a telephone interview yesterday that Saward was operating under a "misapprehension" of how GHA's board function. "I think unfortunately he has gotten second or third-hand impressions of the board's role in Group Health . . . and these are highly distorted," Wool said.

According to Wool, it is the "responsibility of a consumer board to set the major policies" and "to see that the organization does function to be responsive to the membership."

Wool said that GHA had received 150 applications for the executive director's job, but that Saward was the only person who had been offered the position.

Norman Lieberman, persident of the Group Health Association Physicians Association - the union formed to represent GHA's doctors - said that Saward "could have put the organization straight," but that it was clear that "he would have to have a free rein."