Efraim has extended experience in the commercial world in the area of Expansion and Project Management with Walmart in Brazil and was a lieutenant in the Brazilian army. In the UK as CMS Mission Partner, after studying cross-cultural mission at All Nations Christian College in 2012/13, was seconded to work with Opportunity International, a Christian micro-finance NGO, with the focus of implementing new donor grant management systems to the organisation. This involved travelling frequently to several African countries. Also was co-founder of Leap Design Group, utilising his experience in project management and real estate management, helping churches and Christian organisations to have a mission shaped building, when then Leap Discover was born...
Efraim is also a National Programme Lead at Picker Institute Europe and manages the delivery of the Care Quality Commission's National Patient Surveys Programme. This includes the Adult Inpatient, Maternity, Urgent and Emergency Care, and Children and Young People surveys for approximately 50% of the NHS Trusts.