Activist Investor Starboard Value LP, which owns a stake in Mednax Inc., has proposed a majority slate of directors in the latter.

According to a report in The Wall Street Journal,  Mednax, a $2.1 billion healthcare service provider, is under pressure from Starboard Value LP to sell all or a part of itself.

Mednax had a nomination deadline for its board a few days ago, and Starboard is said to have submitted its nominees for board seats.

Informed sources told the WSJ that the two sides are holding negotiations over the composition of the board. Should these not conclude amicably, Starboard may take its battle to the shareholders at the next annual meeting.

Mednax underperforming the market

Shares of Mednax have been declining and have lost a quarter of their value this year. It faces headwinds on profitability due to rising expenditure and a goodwill write-off.

Mednax has faced activist heat before. In 2017, another activist hedge fund, Elliott Management Corp., had accumulated a large stake in the company.

Mednax has taken steps to restructure its business. It sold off its management-service business, MedData, to Frazier Healthcare Partners in October.

Aggressive Starboard may not be denied

Starboard has been in the news recently for a few other transactions.

In September, it took a 7.5% stake in the cloud storage company Box Inc. A month before that, it invested $250 million in Papa John’s International and replaced its CEO.

Further, in October, private equity firms Lindsay Goldberg and American Securities acquired construction giant AECOM’s management services division for $2.4 billion. The sale was a win for Starboard Value, which owned roughly 4% of the company.

Given Starboard’s aggressive approach, therefore, it appears a board reconstitution is only a matter of time.

[Related Story: Activist Hedge Fund Starboard Value Takes Stake in CVS Health]