She takes over the role from Nicky Berry, who will continue in her other role of director of operations until she retires later this summer.
Ms Horan trained as a general nurse at the South Lothian College of Nursing and Midwifery in Edinburgh in 1991 and continued her studies to also qualify as a midwife.
She worked in hospitals across Edinburgh, whilst studying to obtain a degree in Health Studies.
Ms Horan moved to the Borders in the late 1990s and has worked in a range of clinical and leadership roles for the past 22 years, including undertaking post graduate studies in medical imaging at Lancaster University and working as a sonographer. She latterly became the associate director of nursing for acute services and head of midwifery.
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Commenting on her new role, Ms Horan, pictured, said: “I am so proud to take on this role at such a crucial time as we look to recover and remobilise our services.
"I will bring my passion for person-centred care to this role and my aim is to support staff to realise and achieve their potential.”
Ralph Roberts, chief executive, said; “I am delighted that Sarah has now formally joined our executive team at NHS Borders
"She will bring with her extensive experience as well as her passion to the role and I am looking forward to working with her to continue to modernise and improve our local health services in the region.”