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Board Support

New Positions Focus on Care and Management

Job Description Includes Recruitment, Orientation and Involvement

By Joel F. Emrich

Board management is demanding work. Add the complexity of hospitals, health systems and humans into the mix and the demands only rise over time.

Despite the increasing challenges and time required, common practice is for the chief executive, general counsel, development office and/or executive assistant to manage and support the board. While this approach may work to varying degrees, opportunities to enhance the board experience for all involved may be missed.

New positions are being created in and outside of health care that are dedicated to the care and management of boards. These positions report to the office of the president and often have a dual-reporting relationship to the chief executive and another member of senior management, such as the chief of staff.

Primary functions

Professional titles are at the director level or higher e.g., director of board relations/affairs/engagement/governance, etc. And while titles vary, the primary functions of these positions are comparable. Examples include:

  • Recruitment: Working closely with the Governance and Nominating Committee, establishes a formal board and committee member recruitment process involving the identification of attributes needed in new members through gap analysis; sets recruitment targets across the spectrum of diversity; and supports, tracks and communicates progress made on prospect cultivation efforts to ensure a transparent, equitable and efficient recruitment process.
  • Orientation: Serves as the primary point of contact for the onboarding of new board and committee members; creates and/or coordinates a formal orientation program available to new and existing trustees; develops resources to support orientation efforts such as a trustee handbook or board website; and monitors progress on individual and collective orientation objectives.
  • Involvement: Becomes a go-to resource on governance and board relations; responds to confidential, time-sensitive inquiries and personal requests from trustees; drafts and distributes formal and informal communications on behalf of board and executive leadership; increases usage of digital board portals through orientation and expanded offerings; and identifies board education opportunities as part of annual education plans.

Additional responsibilities

In addition to these core functions, board professionals can play a key role in the planning and execution of board and committee meetings. This includes setting agendas to be discussed by chairs and management, creating talking points and run-of-show, editing presentations, facilitating in-person or remote meetings and overseeing the drafting of minutes. These individuals are in a unique position to also establish the annual governance calendar including meeting dates, charts of work and deliverables.

Board professionals will likely collaborate across departments on a range of governance matters. A primary example is the annual conflict of interest questionnaire, often done in partnership with colleagues in legal and compliance. Collaboration might involve the board professional using established relationships with trustees to expedite the process, field sensitive questions and ensure completion.

The board professional can work with others on board assessment and restructuring initiatives. This might include identifying an appropriate governance consultant; facilitating trustee interviews or surveys; making recommendations as to process and expected outcomes; tracking implementation efforts; and communicating objectives and progress.

The office of development is usually a key partner with the office of board relations. This is especially the case in relationship management. Both can work together on the identification and recruitment of new trustees, for example. Further, they can help with trustee orientation and retention through activities such as introductions to hospital leadership and clinicians, tours of facilities and program sites and the development of individual or group engagement strategies.

Health care organizations interested in such a position are best served by considering candidate qualifications and capabilities. At least five years working with boards and high-level executives is recommended. A bachelor’s degree should be required, with a preference for a master’s degree in health care or business administration.

Speaking of capabilities, strict adherence to confidentiality and strong diplomacy skills are essential. Excellent communication abilities, written and verbal, are prerequisite. The ability to perform consistently and calmly under pressure is critical. A passion to work with people from various backgrounds, including those in positions of power, is key.

New positions bring new opportunities. Board professionals provide “one-stop shopping” for all trustees and staff interested in governance and board matters. They can serve as a central hub for all communications and relationships involving the board. They bring with them proven practices and new tools to use. Taken together, these functions make the board and its activities more accessible and transparent.

Joel F. Emrich, MHA, ( is Director, Office of Board Relations for Montefiore Health System and Albert Einstein College of Medicine, New York.

Please note that the views of authors do not always reflect the views of AHA.