Microsoft's Health & Life Sciences Solutions organization is seeking a Principal Site Reliability Engineer to join their interdisciplinary team working on next-generation healthcare solutions. This role focuses on ensuring the reliability and performance of database systems, particularly Azure SQL and CosmosDB, while supporting healthcare-oriented copilots. The position offers a competitive base salary range of $137,600 - $267,000 (higher in SF and NYC areas) and requires 8+ years of technical experience. The role combines database expertise with healthcare innovation, working in a collaborative environment to design and maintain robust, scalable database solutions. The successful candidate will be responsible for performance optimization, disaster recovery, security implementation, and mentoring team members while contributing to Microsoft's mission of empowering global healthcare outcomes. The position includes comprehensive benefits and supports up to 100% remote work with 0-25% travel requirements.