Job Summary
We're looking for a Database Developer to own and evolve the data layer of a cloud-hosted healthcare SaaS platform. You'll design and optimize stored procedures, build reporting pipelines, tune performance in a high-concurrency environment, and collaborate with application developers on data access patterns — while also helping migrate legacy T-SQL logic into modern .NET services.
What You'll DoDesign, develop, and optimize stored procedures, functions, views, and triggers in SQL Server
Own database schema design, migrations, and deployments for a multi-tenant SaaS application
Build and maintain T-SQL reporting data warehouses — aggregation logic and scheduled jobs
Performance tune slow queries — execution plan analysis, index strategy, statistics management, blocking/deadlock resolution
Write operational data scripts for migrations, corrections, and bulk operations
Collaborate with .NET developers to design efficient data access patterns (Entity Framework 6 and EF Core)
Support data flows for third-party integrations — staging tables, validation, reconciliation
Implement audit trails, row-level security, and compliance controls for healthcare (HIPAA/PHI) data
Participate in CI/CD for database changes — DACPAC deployments, scripted migrations, pull request reviews
4–6 years hands-on experience with SQL Server (2016+)
Expert-level T-SQL — complex stored procedures, CTEs, window functions, dynamic SQL, temp tables, cursor optimization
Performance tuning — execution plans, index design, Query Store, statistics, concurrency management
Database design — normalization, denormalization for reporting, multi-tenant schema patterns
SSDT / SQL Server Data Tools — database projects, schema compare, DACPAC deployments
Entity Framework 6 or EF Core — understanding ORM-generated SQL, N+1 detection, migrations
Git-based workflow — pull requests, code review for SQL, branching strategies
Strong debugging skills — tracing data flow from application through ORM to stored procedures
Data warehousing — star/snowflake schemas, reporting aggregation
C# / .NET basics — ability to read service/repository code and understand data access layer patterns
Healthcare domain — HL7, clinical data models, HIPAA compliance
Azure Pipelines or Jenkins for database CI/CD
AWS services (Lambda, S3, SQS) for data integration scenarios
MongoDB (document store syncing to SQL Server)
Experience migrating stored procedure logic into application-layer code (DDD, Clean Architecture)
Terraform for infrastructure provisioning
Netsmart is proud to be an equal opportunity workplace and is an affirmative action employer, providing equal employment and advancement opportunities to all individuals. We celebrate diversity and are committed to creating an inclusive environment for all associates. All employment decisions at Netsmart, including but not limited to recruiting, hiring, promotion and transfer, are based on performance, qualifications, abilities, education and experience. Netsmart does not discriminate in employment opportunities or practices based on race, color, religion, sex (including pregnancy), sexual orientation, gender identity or expression, national origin, age, physical or mental disability, past or present military service, or any other status protected by the laws or regulations in the locations where we operate.
Netsmart desires to provide a healthy and safe workplace and, as a government contractor, Netsmart is committed to maintaining a drug-free workplace in accordance with applicable federal law. Pursuant to Netsmart policy, all post-offer candidates are required to successfully complete a pre-employment background check, which is provided at Netsmart’s sole expense.
Skills Required
- 4–6 years of hands-on experience with SQL Server 2016 or newer
- Expert-level T-SQL, including stored procedures, CTEs, window functions, dynamic SQL, temporary tables, and cursor optimization
- Performance tuning experience with execution plans, index design, Query Store, statistics, and concurrency management
- Database design experience, including normalization, reporting denormalization, and multi-tenant schema patterns
- SSDT / SQL Server Data Tools experience with database projects, schema comparison, and DACPAC deployments
- Entity Framework 6 or EF Core experience, including ORM-generated SQL, N+1 detection, and migrations
- Git-based workflow experience with pull requests, SQL code review, and branching strategies
- Strong debugging skills tracing data flow from applications through ORMs to stored procedures
- Data warehousing experience with star or snowflake schemas and reporting aggregation
- C# and .NET fundamentals for understanding service, repository, and data access patterns
- Healthcare domain experience, including HL7, clinical data models, or HIPAA compliance
- Azure Pipelines or Jenkins experience for database CI/CD
- AWS Lambda, S3, or SQS experience for data integration
- MongoDB experience syncing document-store data to SQL Server
- Experience migrating stored procedure logic into application-layer code using DDD or Clean Architecture
- Terraform experience for infrastructure provisioning
NetSmart Compensation & Benefits Highlights
The following summarizes recurring compensation and benefits themes identified from responses generated by popular LLMs to common candidate questions about NetSmart and has not been reviewed or approved by NetSmart.
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Wellbeing & Lifestyle Benefits — Offerings include a designated mental wellness day, paid volunteer time, telehealth, wellness events, and free 1:1 sessions with counselors and coaches. These wellbeing resources are positioned as stronger than many employers.
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Healthcare Strength — Medical, dental, and vision coverage are paired with short- and long‑term disability and telehealth. The breadth of core health coverage aligns with a comprehensive package.
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Leave & Time Off Breadth — PTO, paid holidays, paid volunteer time, and a designated mental wellness day are part of the offering, with some materials referencing flexible or unlimited PTO. This variety provides multiple avenues for time away.
NetSmart Insights
What We Do
Netsmart designs, builds and delivers electronic health records (EHRs), solutions and services that are powerful, intuitive and easy-to-use. Our platform provides accurate, up-to-date information that is easily accessible to care team members in behavioral health, care at home, senior living and social services. We make the complex simple and personalized so our clients can concentrate on what they do best: provide services and treatment that support whole-person care. By leveraging the powerful Netsmart network, care providers can seamlessly and securely integrate information across communities, collaborate on the most effective treatments and improve outcomes for those in their care. Our streamlined systems and personalized workflows put relevant information at the fingertips of users when and where they need it. For 50 years, Netsmart has been committed to providing a common platform to integrate care. SIMPLE. PERSONAL. POWERFUL. Our more than 2,200 associates work hand-in-hand with our 600,000+ users in more than 25,000 organizations across the U.S. to develop and deploy technology that automates and coordinates everything from clinical to financial to administrative.
