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We are a healthcare technology company that provides platforms and solutions to improve the management and access of cost-effective pharmacy benefits. Our technology helps enterprise and partnership clients simplify their businesses and helps consumers save on prescriptions.

As a leader in SaaS technology for healthcare, we offer innovative solutions with integrated intelligence on a single enterprise platform that connects the pharmacy ecosystem. With our expertise and modern, modular platform, our partners use real-time data to transform their business performance and optimize their innovative models in the marketplace.

Position Summary:

We are looking for a growth-minded Database Performance Engineer with strong SQL Server expertise to support our production and non-production environments. This role provides day-to-day database support for .NET (LINQ/Entity Framework) applications and is ideal for someone who thrives on query tuning, index optimization, and helping teams scale systems efficiently. You'll work in a hybrid environment consisting of SQL Server and Postgres on AWS RDS, alongside some MySQL and MongoDB.

We are a 24/7/365 organization, and this role requires participation in an on-call rotation.

Essential Responsibilities:

Use monitoring tools (Solarwinds DPA, native DMV queries, AWS PI, Atlas, etc.) to identify bottlenecks and recommend tuning strategies. Collaborate with .NET developers to improve query design, ORM efficiency, and schema changes. Review Git pull requests related to data models, indexing, and SQL logic. Support SDLC lifecycle processes through deployment automation and environment refreshes. Manage access provisioning, schema changes, and data replication jobs. Participate in weekly production releases and hotfix cycles. Monitor and tune high-traffic production systems using index strategies, statistics, and plan analysis. Respond to ad hoc data access and reporting requests with performance considerations in mind. Apply patches and updates in alignment with change controls and system stability. Assist in audits and compliance reviews (HIPAA, ISPE, ARS, etc.). Requirements:

2+ years of experience in a backend, data, or database engineering role. Strong SQL skills and familiarity with one or more relational databases (MySQL, PostgreSQL, or SQL Server preferred). Hands-on experience reading and interpreting query execution plans. An understanding of indexing strategies and how they impact performance. Curiosity to dig into performance issues and tenacity to find root causes. Able to respond to calls within the SLA when on-call Bonus Skills:

Exposure to other databases (MySQL, MongoDB, or Postgres). Experience with data modeling or schema design best practices. Familiarity with replication strategies (any vendor or platform). Experience in regulated environments (Medicaid, Medicare, PBM). Jira, Confluence, Bitbucket familiarity. Exposure to infrastructure-as-code (e.g., Terraform, CloudFormation). .NET or Python scripting exposure (for dev support or tooling). Salary Range: $98,000 - $120,000

RxSense believes that a diverse workforce is a more talented and productive workforce. As such, we are an Equal Opportunity and Affirmative Action employer. Our recruitment process is free from discriminatory hiring practices and all qualified applicants are considered for employment without regard to race, color, religion, sex, gender, sexual orientation, gender identity, ancestry, age, or national origin. Neither will qualified applicants be discriminated against on the basis of disability or protected veteran status. We believe in the strength of the collaboration, creativity and sense of community a diverse workforce brings.

In Office Policy : If you are located within 50 miles of the following offices, this position will hybrid.

Boston, MA Princeton, NJ New York City, NY West Palm Beach, Florida