Ralph is the executive chairman of Seminal Health in Philadelphia, national advisor to Manatt Health, and senior fellow at LDI of Penn Medicine and The Wharton School at the University of Pennsylvania. He is a retired CEO of University of Pennsylvania Health System, where he served from 2003 to 2019.  He was, from 1985 to 2001, the president of the University of Chicago Hospitals. 

Ralph has also served as chairman of the Association of American Medical Colleges (AAMC), the Council of Teaching Hospitals and Health Systems (COTH), the University Healthsystem Consortium (UHC), and NORC. He was a past commissioner of The Joint Commission (TJC) and the Medicare Payment Advisory Commission (MedPAC) and director of the National Committee for Quality Assurance (NCQA) and ECRI.  

He is a member of the National Academy of Medicine (NAM), a fellow of the American Association for the Advancement of Science (AAAS), chairman of the Philadelphia Orchestra and Kimmel Center (POKC), and a trustee of WHYY (Philadelphia NPR).