This one real test score is such an outlier that I don't think you should be too concerned about it. If you take a real test tomorrow, from your scoring history I'd be very confident you'd score in the Q46-Q50 range and in the V36-V39 range. When test takers get outlier scores like yours, there are a few common explanations, though it's hard to tell which might apply in your case. Test anxiety is the most common explanation, but that does not seem to have affected you. If you were tired on test day (you mention a demanding job) that might be an explanation. Or there might not be any identifiable cause, and you may just have had an unusually bad or unlucky day. That's not likely to happen again.
I can see why your score was what it was, from the ESR, but because you've performed better on every other test, I wouldn't make any major changes to your approach. One thing about ESRs is that their breakdowns by question type (when it tells you how good you are at SC, CR, RC, or Geometry, Algebra, etc) are based on such small samples of questions that they don't mean all that much. In Quant, for example, all I'd really be even moderately confident saying is that you're strong in Geometry. The differences in the Verbal breakdowns aren't large enough to be significant.
In the Verbal section, your performance early on was well below normal for you. The difficulty graphs on ESRs are condensed, so when reading your Verbal difficulty graph, the leftmost blue dot is about as low as those dots get. In the first quarter of the test, you were getting the absolute easiest questions right, but were getting 500-level questions wrong. Then in the second quarter of the test you were still getting some 400-level questions wrong, and by the time the first half of the test was over, the algorithm didn't have a high opinion of your Verbal ability. Obviously you haven't performed that way on any other test, and I'm not sure what happened on this one, but whatever happened, it's not likely to happen again. One thing I notice is that your Verbal timing was rushed right at the beginning (if you did Verbal first, maybe there was some adrenaline responsible, but if not, then I'm not sure what happened). So even if you didn't feel test pressure, you might have adopted a pacing strategy different from your normal one, and that might have led to mistakes early on that you don't normally make. If you can relax and slow down slightly at the start, and just make sure you're getting questions right when you understand the logic behind them, that should give you a better chance at a strong score.
You had a hard Quant test overall, and I'm a bit surprised by the score you got -- considering that almost all of your questions were hard, I'd have expected your performance on this test to produce a Q45 or so. It's probably because your hit rate in the final quarter wasn't too strong (and that happened because you were short on time) that your score dipped to the Q43.
So in Quant, it appears you need to speed up a bit, and in Verbal you need to slow down a bit, but any adjustments you make should be minor, because your diagnostic scores are very strong. To save time in Q, you'd normally want to simply be willing to move on from very hard questions a bit more quickly, unless you can see a path to a solution (it's not a good idea to try to save time by rushing through questions you know how to solve -- then you'll more likely make careless errors on easier questions, and wrong answers on easy questions are hard to recover from). Naturally if you can learn faster Quant methods, that will also help. If you have a similarly difficult Q test next time, your score will boil down to how well you answer hard questions, so you might want to devote more time to practicing realistic high-level questions (I sell several problem sets full of very challenging questions - feel free to contact me if you might find those helpful). But even if you did nothing at all, I think you're in a great position to score a 700-720, and one unusual test score doesn't change that. Good luck!