It's really hard for a fresher to get into the "SQL Developer" position. They usually want an SQL Ninja. Even places hiring a "Junior" SQL Developer want you to have a year's worth of experience.

If you're still at a healthcare place (which has some huge opportunities to learn about databases), you might want to start there as a "junior". Keep in mind that will likely result in a cut in pay compared to being a manager, but there's nothing like having a mentor or two to teach you and getting the "time in service" on systems that you might already know about.

While you're doing that, buy a copy of SQL Server Developer's Edition (Enterprise Edition with special licensing) and hit the books. Check out the Microsoft Web site for certifications and follow the plan.