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Summary of Significant Accounting Policies - Summary of Impact of Adoption of Accounting Standards (Details) - USD ($)
$ / shares in Units, shares in Thousands, $ in Thousands
 3 Months Ended 12 Months Ended
Dec. 31, 2019
Sep. 30, 2019
Jun. 30, 2019
Mar. 31, 2019
Dec. 31, 2018
Sep. 30, 2018
Jun. 30, 2018
Mar. 31, 2018
Dec. 31, 2019
Dec. 31, 2018
Dec. 31, 2017
Jan. 01, 2019
Jan. 01, 2018
Dec. 31, 2016
Revenue:                            
Total revenue $ 229,886 $ 216,238 $ 214,104 $ 200,741 $ 192,115 $ 179,253 $ 170,144 $ 163,077 $ 860,969 $ 704,589 $ 436,152      
Operating expenses:                            
Direct service costs, excluding depreciation and amortization                 321,006 252,284 211,773      
Reimbursed out-of-pocket expenses                 294,266 236,775 49,690      
Total direct costs 167,187 152,070 150,312 145,703 131,133 123,996 116,676 117,254 615,272 489,059 261,463      
Total operating expenses                 733,706 603,541 371,294      
Income from operations 36,118 29,991 35,259 25,895 30,666 26,918 23,345 20,119 127,263 101,048 64,858      
Income before income taxes                 124,832 93,951 56,945      
Income tax provision                 24,389 20,766 17,823      
Net income $ 29,813 $ 23,977 $ 27,455 $ 19,198 $ 22,761 $ 19,305 $ 16,568 $ 14,551 $ 100,443 $ 73,185 $ 39,122      
Net income per share attributable to common shareholders:                            
Basic $ 0.82 $ 0.67 $ 0.76 $ 0.54 $ 0.64 $ 0.54 $ 0.46 $ 0.41 $ 2.79 $ 2.05 $ 1.00      
Diluted $ 0.78 $ 0.63 $ 0.73 $ 0.51 $ 0.61 $ 0.52 $ 0.45 $ 0.40 $ 2.67 $ 1.97 $ 0.98      
Weighted average common shares outstanding:                            
Basic                 35,881 35,547 39,056      
Diluted                 37,576 36,912 39,839      
Current assets:                            
Accounts receivable and unbilled, net $ 155,662       $ 133,449       $ 155,662 $ 133,449        
Prepaid expenses and other current assets 29,446       21,383       29,446 21,383        
Total current assets 317,028       178,114       317,028 178,114        
Deferred income taxes 376       713       376 713        
Property and equipment, net 47,292       52,255       47,292 52,255        
Operating lease right-of-use assets 52,152       0       52,152 0        
Total assets 1,143,071       967,933       1,143,071 967,933        
Current liabilities:                            
Accrued expenses 109,252       87,493       109,252 87,493        
Pre-funded study costs         0         0        
Advanced billings 192,359       147,935       192,359 147,935        
Other current liabilities 18,987       4,861       18,987 4,861        
Total current liabilities 343,002       257,026       343,002 257,026        
Operating lease liabilities 45,212       0       45,212 0        
Deemed landlord liability, less current portion 0       24,484       0 24,484        
Deferred income tax liability 12,849       439       12,849 439        
Other long-term liabilities 15,725       16,560       15,725 16,560        
Total liabilities 416,788       378,230       416,788 378,230        
Shareholders’ equity:                            
Accumulated deficit 68,109       (41,487)       68,109 (41,487)        
Total shareholders’ equity 726,283       589,703       726,283 589,703 $ 503,530     $ 610,710
Total liabilities and shareholders’ equity $ 1,143,071       967,933       1,143,071 967,933        
CASH FLOWS FROM OPERATING ACTIVITIES:                            
Net income                 100,443 73,185 39,122      
Adjustments to reconcile net income to net cash provided by operating activities:                            
Deferred income tax provision                 10,050 3,942 3,237      
Changes in assets and liabilities:                            
Accounts receivable and unbilled, net                 (21,256) (27,047) (2,898)      
Prepaid expenses and other current assets                 (7,381) (1,241) (3,533)      
Accrued expenses                 21,824 29,029 (1,313)      
Pre-funded study costs                 0 0 5,292      
Advanced billings                 44,584 35,593 7,735      
Other assets and liabilities, net                 2,121 1,925 2,782      
Net cash provided by operating activities                 201,867 156,584 97,385      
Revenue Net                            
Revenue:                            
Total revenue                 860,969 704,589 0      
Direct Service Revenue                            
Revenue:                            
Total revenue                 0 0 386,462      
Reimbursed Out-of-Pocket Revenue                            
Revenue:                            
Total revenue                 $ 0 0 $ 49,690      
ASU 2014-09 | Impact of Adoption of ASC 606 - Adjustments                            
Revenue:                            
Total revenue                   (155,221)        
Operating expenses:                            
Direct service costs, excluding depreciation and amortization                   0        
Reimbursed out-of-pocket expenses                   (165,470)        
Total direct costs                   (165,470)        
Total operating expenses                   (165,470)        
Income from operations                   10,249        
Income before income taxes                   10,249        
Income tax provision                   1,882        
Net income                   $ 8,367        
Net income per share attributable to common shareholders:                            
Basic                   $ 0.24        
Diluted                   $ 0.23        
Weighted average common shares outstanding:                            
Basic                   0        
Diluted                   0        
Current assets:                            
Accounts receivable and unbilled, net         (28,729)         $ (28,729)     $ 23,900  
Prepaid expenses and other current assets         1,147         1,147        
Total current assets         (27,582)         (27,582)        
Deferred income taxes         (389)         (389)        
Total assets         (27,971)         (27,971)        
Current liabilities:                            
Accrued expenses         (51,109)         (51,109)     35,100  
Pre-funded study costs         61,156         61,156     (57,400)  
Advanced billings         (41,732)         (41,732)     38,900  
Other current liabilities         (590)         (590)        
Total current liabilities         (32,275)         (32,275)        
Deferred income tax liability         2,049         2,049     (1,600)  
Other long-term liabilities         (382)         (382)        
Total liabilities         (30,608)         (30,608)        
Shareholders’ equity:                            
Accumulated deficit         2,637         2,637     $ 5,700  
Total shareholders’ equity         2,637         2,637        
Total liabilities and shareholders’ equity         (27,971)         (27,971)        
CASH FLOWS FROM OPERATING ACTIVITIES:                            
Net income                   8,367        
Adjustments to reconcile net income to net cash provided by operating activities:                            
Deferred income tax provision                   4,002        
Changes in assets and liabilities:                            
Accounts receivable and unbilled, net                   4,842        
Prepaid expenses and other current assets                   (1,147)        
Accrued expenses                   (15,967)        
Pre-funded study costs                   3,782        
Advanced billings                   (2,907)        
Other assets and liabilities, net                   (972)        
Net cash provided by operating activities                   0        
ASU 2014-09 | Impact of Adoption of ASC 606 - Adjustments | Revenue Net                            
Revenue:                            
Total revenue                   (704,589)        
ASU 2014-09 | Impact of Adoption of ASC 606 - Adjustments | Direct Service Revenue                            
Revenue:                            
Total revenue                   478,063        
ASU 2014-09 | Impact of Adoption of ASC 606 - Adjustments | Reimbursed Out-of-Pocket Revenue                            
Revenue:                            
Total revenue                   71,305        
ASU 2014-09 | Impact of Adoption of ASC 606 - As Revised under ASC 605                            
Revenue:                            
Total revenue                   549,368        
Operating expenses:                            
Direct service costs, excluding depreciation and amortization                   252,284        
Reimbursed out-of-pocket expenses                   71,305        
Total direct costs                   323,589        
Total operating expenses                   438,071        
Income from operations                   111,297        
Income before income taxes                   104,200        
Income tax provision                   22,648        
Net income                   $ 81,552        
Net income per share attributable to common shareholders:                            
Basic                   $ 2.29        
Diluted                   $ 2.20        
Weighted average common shares outstanding:                            
Basic                   35,547        
Diluted                   36,912        
Current assets:                            
Accounts receivable and unbilled, net         104,720         $ 104,720        
Prepaid expenses and other current assets         22,530         22,530        
Total current assets         150,532         150,532        
Deferred income taxes         324         324        
Total assets         939,962         939,962        
Current liabilities:                            
Accrued expenses         36,384         36,384        
Pre-funded study costs         61,156         61,156        
Advanced billings         106,203         106,203        
Other current liabilities         4,271         4,271        
Total current liabilities         224,751         224,751        
Deferred income tax liability         2,488         2,488        
Other long-term liabilities         16,178         16,178        
Total liabilities         347,622         347,622        
Shareholders’ equity:                            
Accumulated deficit         (38,850)         (38,850)        
Total shareholders’ equity         592,340         592,340        
Total liabilities and shareholders’ equity         $ 939,962         939,962        
CASH FLOWS FROM OPERATING ACTIVITIES:                            
Net income                   81,552        
Adjustments to reconcile net income to net cash provided by operating activities:                            
Deferred income tax provision                   7,944        
Changes in assets and liabilities:                            
Accounts receivable and unbilled, net                   (22,205)        
Prepaid expenses and other current assets                   (2,388)        
Accrued expenses                   13,062        
Pre-funded study costs                   3,782        
Advanced billings                   32,686        
Other assets and liabilities, net                   953        
Net cash provided by operating activities                   156,584        
ASU 2014-09 | Impact of Adoption of ASC 606 - As Revised under ASC 605 | Revenue Net                            
Revenue:                            
Total revenue                   0        
ASU 2014-09 | Impact of Adoption of ASC 606 - As Revised under ASC 605 | Direct Service Revenue                            
Revenue:                            
Total revenue                   478,063        
ASU 2014-09 | Impact of Adoption of ASC 606 - As Revised under ASC 605 | Reimbursed Out-of-Pocket Revenue                            
Revenue:                            
Total revenue                   $ 71,305        
ASU 2016-02                            
Current assets:                            
Prepaid expenses and other current assets                       $ 21,013    
Total current assets                       177,744    
Property and equipment, net                       37,613    
Operating lease right-of-use assets                       51,854    
Total assets                       1,004,775    
Current liabilities:                            
Other current liabilities                       10,951    
Total current liabilities                       263,116    
Operating lease liabilities                       45,294    
Deemed landlord liability, less current portion                       0    
Deferred income tax liability                       3,158    
Other long-term liabilities                       14,630    
Total liabilities                       405,919    
Shareholders’ equity:                            
Accumulated deficit                       (32,334)    
Total shareholders’ equity                       598,856    
Total liabilities and shareholders’ equity                       1,004,775    
ASU 2016-02 | Adjustments                            
Current assets:                            
Prepaid expenses and other current assets                       (370)    
Total current assets                       (370)    
Property and equipment, net                       (14,642)    
Operating lease right-of-use assets                       51,854    
Total assets                       36,842    
Current liabilities:                            
Other current liabilities                       6,090    
Total current liabilities                       6,090    
Operating lease liabilities                       45,294    
Deemed landlord liability, less current portion                       (24,484)    
Deferred income tax liability                       2,719    
Other long-term liabilities                       (1,930)    
Total liabilities                       27,689    
Shareholders’ equity:                            
Accumulated deficit                       9,153    
Total shareholders’ equity                       9,153    
Total liabilities and shareholders’ equity                       $ 36,842