Poly(ethylene glycol) (PEG) and PEG derivatives, i.e., polyethers, have transformed medicine in the 21st century primarily due their biocompatibility and tunable properties. PEG derivatives with functional groups attached as pendants and at the chain ends (hetero-multifunctional polymers) provide numerous opportunities for synthetic modification. In this work, we aimed to exploit these functionalities through precise initiator design, resulting in highly tunable, biocompatible polyethers with clinical relevance in therapeutics (i.e., hapten-targeted immunotherapies) and diagnostics (i.e., medical imaging). Aluminum-based initiators were synthesized which (1) incorporate highly reactive small molecules to functional polyether chain ends, (2) produce nanoparticle-polyether conjugates with controlled brush properties through surface-initiation, and (3) yield block-co-polymers consisting of a PEG block and a functional poly(epichlorohydrin) (PECH) block for facile routes of synthetic modification to achieve desired properties. The structural and compositional control was established for polymerizations from all novel initiators and synthetic modification was achieved for the anticipated use in therapeutics and/or diagnostics. Ultimately, this work furthers our understanding of polymer chemistry/synthesis and informs future design of polymer-based materials for applications in human health.