Segment and Geographic Information (Details)
$ in Thousands
12 Months Ended
Dec. 31, 2015
USD ($)
segment
Dec. 31, 2014
USD ($)
Dec. 31, 2013
USD ($)
Segment Reporting [Abstract]      
Number of operating segments (segments) | segment 4    
Segment Reporting Information [Line Items]      
Revenues before reimbursements $ 1,170,385 $ 1,142,851 $ 1,163,445
Assets 783,406 789,319  
U.S. Services      
Segment Reporting Information [Line Items]      
Revenues before reimbursements 242,488 215,385 203,916
International      
Segment Reporting Information [Line Items]      
Revenues before reimbursements 506,650 488,284 488,488
Broadspire      
Segment Reporting Information [Line Items]      
Revenues before reimbursements 293,032 268,890 252,242
Operating segments      
Segment Reporting Information [Line Items]      
Segment operating earnings 87,025 81,701 105,687
Depreciation and amortization [1] 25,983 24,283 21,807
Assets 591,736 591,563 608,451
Operating segments | U.S. Services      
Segment Reporting Information [Line Items]      
Revenues before reimbursements 242,488 215,385 203,916
Segment operating earnings 32,702 18,039 11,895
Depreciation and amortization [1] 2,780 2,415 1,822
Assets 49,252 46,846 47,208
Operating segments | International      
Segment Reporting Information [Line Items]      
Revenues before reimbursements 506,650 488,284 488,488
Segment operating earnings 18,799 25,344 38,795
Depreciation and amortization [1] 8,579 7,525 7,352
Assets 349,358 318,689 339,435
Operating segments | Broadspire      
Segment Reporting Information [Line Items]      
Revenues before reimbursements 293,032 268,890 252,242
Segment operating earnings 24,017 15,469 8,245
Depreciation and amortization [1] 8,841 8,448 7,381
Assets 105,518 103,899 109,939
Operating segments | Garden City Group      
Segment Reporting Information [Line Items]      
Revenues before reimbursements 128,215 170,292 218,799
Segment operating earnings 11,507 22,849 46,752
Depreciation and amortization [1] 5,783 5,895 5,252
Assets $ 87,608 $ 122,129 $ 111,869
[1] Excludes amortization expense of finite-lived customer relationships and trade name intangible assets.