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.
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