About Medical Guardian: Medical Guardian is a fast-growing digital health and safety company on a mission to help people live a life without limits. With 14 consecutive years on the Inc. 5000 list of Fastest Growing Companies, we are redefining what it means to age confidently and independently.
We support over 625,000 members nationwide with life-saving emergency response systems and remote patient monitoring solutions. Trusted by families, healthcare providers, and care managers, our work is powered by a culture of innovation, compassion, and purpose.
Role Summary: The Senior Database Engineer is Medical Guardian's primary owner and steward of the enterprise database platform, accountable for the availability, performance, recoverability, security, and operational health of the organization's data infrastructure, including Microsoft SQL Server, Azure Cosmos DB, and future database technologies.
As Medical Guardian's dedicated database subject matter expert, this individual owns database administration, performance optimization, backup and recovery, disaster recovery readiness, operational automation, database security, and incident response for critical data systems supporting members, caregivers, internal operations, applications, analytics, and emerging technology initiatives, including Medical Guardian's Nexus platform migration and ongoing data platform consolidation across Azure Data Warehouse, Azure Data Lake, Databricks, and Salesforce Data Cloud.
This role works closely with the Data Operations, AI/ML, and Infrastructure teams, providing database expertise and engineering support across initiatives that depend on Medical Guardian's enterprise data platforms. It also partners with Security, Compliance, and Architecture to ensure database services remain resilient, scalable, recoverable, secure, and operationally sound.
This is a dedicated database engineering role. Database availability, security, integrity, performance, and recoverability are the sole primary accountability of this position.
Key Responsibilities: Database Administration and Platform Ownership
- Serve as Medical Guardian's primary database subject matter expert and technical owner for enterprise database platforms.
- Establish and maintain database operational standards, governance practices, maintenance procedures, lifecycle management processes, and engineering best practices.
- Own the strategic roadmap for database platforms, including modernization, upgrades, migrations, and cloud adoption, including database components of the Nexus transformation.
- Administer and support Microsoft SQL Server across production, development, testing, and disaster recovery environments, and Azure Cosmos DB and future cloud-native database technologies as the platform footprint evolves.
- Manage database installations, upgrades, patching, migrations, configuration management, and version control.
- Maintain database maintenance schedules including backups, integrity checks, index maintenance, statistics updates, and patch management.
- Provide technical guidance to Engineering, Data Operations, AI/ML, Infrastructure, and Architecture on database design, scalability, performance, security, and operational readiness.
- Evaluate emerging database technologies, tools, and operating practices against business and technical objectives.
Performance, Reliability, and Capacity
- Monitor, analyze, and continuously improve database performance across business-critical applications and services, including index strategy, execution plans, blocking, deadlocks, and resource utilization.
- Partner with Engineering, Data Operations, and AI/ML teams to optimize application data-access patterns, SQL performance, data models, and analytics/AI workloads.
- Develop performance baselines, conduct proactive assessments, and remediate issues before they affect production.
- Build and maintain observability, including dashboards, alerting, health checks, and operational reporting, for database availability, health, and capacity.
- Manage database file structures, filegroups, partitioning, and storage growth; forecast capacity requirements and remediate constraints ahead of impact.
- Identify recurring operational issues and implement sustainable engineering fixes rather than manual workarounds.
Backup, Recovery, and Business Continuity
- Own enterprise database backup, retention, restoration, and recovery strategy across supported platforms.
- Define and maintain Recovery Point Objectives (RPO) and Recovery Time Objectives (RTO) in partnership with Technology leadership, and report status against these targets on a defined cadence.
- Execute and document routine backup restoration testing to verify integrity and recovery readiness, retaining evidence for audit purposes.
- Partner with Infrastructure on disaster recovery architecture, failover processes, and resiliency planning; support DR exercises and business continuity events.
Incident Response and Operational Readiness
- Serve as the primary database subject matter expert in Technology's incident response process, including availability, performance, integrity, replication, and recovery events.
- Participate in an on-call rotation and provide after-hours support for critical database incidents.
- Coordinate with Engineering, Data Operations, AI/ML, Infrastructure, Security, and vendors during active incidents to restore service safely and quickly.
- Maintain recovery runbooks, DR procedures, and incident response documentation; lead root cause analysis and drive corrective action.
- Coordinate with Microsoft and other technology vendors during escalated incidents and platform outages.
Automation and Database Engineering
- Automate repetitive database administration and operational activities to improve reliability and reduce manual effort.
- Develop scripts, tooling, and workflows supporting provisioning, maintenance, monitoring, recovery, deployment, and operational reporting (PowerShell, T-SQL, Python).
- Collaborate with Engineering and Infrastructure on database deployment automation, CI/CD, and release validation, and support Infrastructure-as-Code initiatives where they intersect with database platforms.
- Maintain database automation code using source control, peer review, and testing practices consistent with Engineering standards.
- Use AI-assisted engineering tools to accelerate troubleshooting, analysis, documentation, and administration, applying appropriate judgment and validation.
Security, Compliance, and Data Protection
- Implement and maintain database security controls, including permissions, encryption, auditing, access governance, and data protection, in alignment with MG-SEC-DC-001 and applicable data classification requirements.
- Partner with Security and Compliance to support HIPAA, SOC 2 Type II, PCI-DSS, and HITRUST i1 obligations specific to database platforms, including control mapping and evidence collection for audits.
- Monitor and remediate database vulnerabilities within established risk and remediation timelines.
- Ensure database environments maintain logging, monitoring, auditing, and evidence retention sufficient for compliance assessments.
- Apply least-privilege and secure-configuration principles to all database and automation solutions.
Knowledge Continuity and Cross-Training
- Maintain current, accessible runbooks and architecture documentation sufficient for another qualified engineer to operate and recover database platforms in this individual's absence.
- Partner with Infrastructure and Engineering leadership to build secondary coverage (cross-training or a designated backup) for on-call and disaster recovery response.
- Conduct periodic knowledge-transfer sessions with Infrastructure and Engineering to reduce concentration risk on a single individual.
Cross-Functional Collaboration
- Work closely with Data Operations to support data availability, movement, reporting/analytics needs, and reliable access to enterprise data platforms.
- Partner with the AI/ML team on database architecture, data access, performance, and data pipeline requirements for AI/ML solutions, and support ongoing efforts to reduce duplication across the Salesforce Data Cloud and Azure AI/data backend.
- Collaborate with Infrastructure on hosting, compute, storage, networking, high availability, DR, monitoring, and capacity planning.
- Collaborate with Architecture on database strategy, modernization, technical standards, and platform roadmap, including Nexus.
- Support onboarding of new applications, data solutions, integrations, and AI/ML capabilities by ensuring database requirements are scalable, secure, performant, recoverable, and operationally supportable.
Required Skills and Experience: Database Administration Expertise
- 7+ years of professional experience administering Microsoft SQL Server in enterprise production environments.
- Demonstrated expertise in performance tuning, indexing strategy, query optimization, and workload analysis.
- Experience owning database backup, recovery, disaster recovery, and business continuity processes.
- Strong understanding of SQL Server architecture, storage management, filegroups, partitioning, and high availability technologies.
- Experience supporting database upgrades, migrations, patching, and configuration/lifecycle management.
- Deep understanding of database security, permissions, encryption, auditing, and access management.
Automation and Platform Engineering
- Strong scripting and automation experience using PowerShell, T-SQL, and Python.
- Experience implementing CI/CD practices and deployment automation for database platforms.
- Familiarity with Infrastructure-as-Code concepts and tooling such as Terraform, Bicep, or ARM templates.
- Experience supporting cloud database technologies within Microsoft Azure environments.
- Understanding of monitoring, observability, and logging tooling used to manage enterprise data platforms.
Reliability and Operations
- Experience leading incident response, root cause analysis, and service restoration for database platforms.
- Experience defining and tracking operational metrics for database performance, reliability, utilization, capacity, and recoverability.
- Demonstrated ability to develop operational documentation, recovery procedures, and runbooks.
- Experience supporting regulated environments with formal security, compliance, and audit requirements.
- Familiarity with capacity planning, performance benchmarking, and operational risk management.
Collaboration and Communication
- Strong written and verbal communication skills, able to explain technical concepts to technical and non-technical audiences.
- Ability to balance strategic database initiatives, operational responsibilities, and project commitments.
- Strong analytical, troubleshooting, and problem-solving capabilities.
- Ability to operate independently as the organization's primary database subject matter expert while collaborating effectively across teams.
Other:
- Candidates must be able to work from Philadelphia, PA office on Tuesdays and Wednesdays.
- Must be legally authorized to work in the United States without current or future employer sponsorship.
Preferred Qualifications: - Experience administering Azure Cosmos DB.
- Experience with Azure SQL Database and Azure SQL Managed Instance.
- Experience supporting data engineering, analytics, or data operations teams.
- Experience supporting AI/ML platforms, data pipelines, or machine learning workloads.
- Experience supporting healthcare technology or other highly regulated environments.
- Familiarity with HIPAA, SOC 2 Type II, PCI-DSS, or HITRUST requirements.
- Experience implementing database monitoring and observability platforms.
- Microsoft SQL Server, Azure, or related industry certifications.
- Experience leveraging AI-assisted engineering and operational tools to improve troubleshooting and operational effectiveness.
Preferred Technology Stack: - Microsoft SQL Server
- Azure Cosmos DB
- Azure SQL Database / Azure SQL Managed Instance
- SQL Server Always On Availability Groups
- Azure Monitor / Log Analytics / Application Insights
- Redgate SQL Toolbelt or equivalent database administration tooling
- GitHub Actions / Azure DevOpsa
- PowerShell, T-SQL, Python
- Terraform / Bicep / ARM Templates
- Azure Backup / Recovery Services Vault
- Datadog / OpenTelemetry or equivalent observability platforms
- Git and modern source-control workflows
- REST APIs and application integration technologies
- Medical Guardian's application development, testing, and CI/CD toolchain
Benefits - Health Care Plan (Medical, Dental & Vision)
- Paid Time Off (Vacation, Sick Time Off & Holidays)
- Company Paid Short Term Disability and Life Insurance
- Retirement Plan (401k) with Company Match
