Design, build, and optimize enterprise SQL Server databases for healthcare systems. Perform T-SQL development, performance tuning, partitioning, ETL/SSIS, FHIR-based integrations, reporting (SSRS/Power BI), capacity planning, and ensure HIPAA-compliant data security and high availability.
Key Responsibilities
Database Design & Development
- Design, develop, and maintain complex SQL Server databases supporting enterprise healthcare applications.
- Create and optimize database schemas, tables, indexes, views, stored procedures, functions, and triggers.
- Develop scalable data models supporting patient, provider, care management, clinical, and operational workflows.
- Ensure database structures support evolving business and regulatory requirements.
Performance Optimization
- Analyze and resolve database performance bottlenecks.
- Optimize complex T-SQL queries and stored procedures.
- Design indexing strategies to improve application response times.
- Perform execution plan analysis and SQL code optimization.
- Monitor database performance and proactively identify areas for improvement.
- Support high-volume transactional workloads while maintaining performance SLAs.
Scalability & Capacity Planning
- Assess current database limitations and recommend scalability improvements.
- Design solutions capable of supporting increased user concurrency and transaction volumes.
- Implement partitioning, archiving, caching, and data lifecycle strategies.
- Optimize database architecture for future platform growth and new feature rollouts.
- Collaborate with Technical Architects to define long-term database modernization strategies.
Healthcare Data & Integrations
- Support healthcare interoperability initiatives using FHIR standards.
- Develop and optimize ETL processes for healthcare data exchange.
- Design database structures supporting FHIR resources and healthcare integrations.
- Work with API and integration teams to ensure efficient data access patterns.
- Ensure compliance with healthcare data governance and security requirements.
Reporting & Analytics
- Design and optimize reporting databases and operational data stores.
- Develop SQL-based reporting solutions and data extracts.
- Support Power BI and enterprise reporting initiatives.
- Create scalable reporting mechanisms that minimize application performance impact.
Data Security & Compliance
- Implement database security best practices.
- Manage data access controls and encryption strategies.
- Ensure compliance with HIPAA and healthcare data privacy regulations.
- Participate in audits and compliance reviews.
Requirements
Required Qualifications
Experience
- 8+ years of SQL Server development experience.
- 5+ years working on enterprise-scale applications.
- Experience supporting systems with high transaction volumes and large datasets.
- Proven track record of database performance tuning and optimization.
- Experience working closely with application development teams.
- Microsoft SQL Server 2016/2019/2022
- T-SQL Programming
- Stored Procedures
- Views
- Triggers
- Functions
- Query Optimization
- Index Tuning
- Database Performance Monitoring
- Performance & Scalability
- Execution Plan Analysis
- Database Partitioning
- Index Strategy Design
- Locking and Blocking Analysis
- Deadlock Resolution
- Capacity Planning
- High Availability and Disaster Recovery
- Development & Integration
- SQL Server Integration Services (SSIS)
- ETL Development
- REST API Data Integrations
- Data Migration Strategies
- CI/CD for Database Deployments
- SQL Reporting Services (SSRS)
- Power BI
- Operational Reporting
- Data Warehousing Concepts
Preferred Qualifications
- Healthcare industry experience.
- Knowledge of HL7 and FHIR standards.
- Experience with Electronic Health Record (EHR/EMR) platforms.
- Expertise in Azure SQL and cloud database architectures.
- Experience supporting care management, population health, or patient engagement platforms.
- Familiarity with Azure Data Factory and modern data platform technologies.
Key Deliverables
- During the first 90 days, the successful candidate will:
- Complete a database health and performance assessment.
- Identify and resolve critical performance bottlenecks.
- Optimize high-impact stored procedures and queries.
- Establish database monitoring and performance baselines.
- Create a database scalability roadmap.
- Implement indexing and data access optimization strategies.
- Support new healthcare integration and reporting initiatives.
- Improve data quality and reliability across the platform.
Success Metrics
- Reduction in database response times.
- Improved application performance and user experience.
- Increased concurrent user capacity.
- Reduction in production database incidents.
- Faster reporting and analytics execution.
- Improved scalability to support future platform growth.
- High data quality, security, and system reliability.
Similar Jobs
Agency • Information Technology
Design, develop, optimize, and maintain Oracle databases and PL/SQL code. Build CI/CD pipelines with Jenkins, ensure availability, security, backups and disaster recovery, perform tuning and data modeling, troubleshoot issues, and mentor junior engineers.
Top Skills:
Aws RdsAzure Sql DatabaseCi/CdJenkinsMySQLOraclePl/SqlPostgresSQLSQL Server
Artificial Intelligence • Big Data • Healthtech • Information Technology • Machine Learning • Software • Analytics
Lead sales data, analytics, targeting, and origination for provider commercial markets. Apply AI, automation, and advanced analytics to identify high-potential prospects, drive lead generation, optimize pipeline qualification, partner with sales and marketing, and maintain CRM/data hygiene to support scalable pipeline creation and pursuit efforts.
Top Skills:
AIAnalytics ZoneAutomation ToolsClarivateDefinitiveExcel (Pivot Tables)Generative AiMicrosoft TeamsPower BIPowerPointSalesforceSharepointSQLTableauWord
Cloud • Fintech • Software • Business Intelligence • Consulting • Financial Services
Manage complex tax returns and consulting for partnership clients, evaluate tax agreements, lead teams on engagements, and maintain client relationships.
Top Skills:
Tax-Related Software
What you need to know about the San Francisco Tech Scene
San Francisco and the surrounding Bay Area attracts more startup funding than any other region in the world. Home to Stanford University and UC Berkeley, leading VC firms and several of the world’s most valuable companies, the Bay Area is the place to go for anyone looking to make it big in the tech industry. That said, San Francisco has a lot to offer beyond technology thanks to a thriving art and music scene, excellent food and a short drive to several of the country’s most beautiful recreational areas.
Key Facts About San Francisco Tech
- Number of Tech Workers: 365,500; 13.9% of overall workforce (2024 CompTIA survey)
- Major Tech Employers: Google, Apple, Salesforce, Meta
- Key Industries: Artificial intelligence, cloud computing, fintech, consumer technology, software
- Funding Landscape: $50.5 billion in venture capital funding in 2024 (Pitchbook)
- Notable Investors: Sequoia Capital, Andreessen Horowitz, Bessemer Venture Partners, Greylock Partners, Khosla Ventures, Kleiner Perkins
- Research Centers and Universities: Stanford University; University of California, Berkeley; University of San Francisco; Santa Clara University; Ames Research Center; Center for AI Safety; California Institute for Regenerative Medicine
