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Goodwill and Identifiable Assets (Goodwill) (Details) (USD $)
In Thousands, unless otherwise specified
9 Months Ended 12 Months Ended
Sep. 30, 2014
Dec. 31, 2013
Dec. 31, 2012
Goodwill [Roll Forward]      
Gross goodwill $ 574,023 $ 574,948 $ 617,875
Accumulated impairment loss 0 0 (121,717)
Goodwill 574,023 574,948 496,158
Goodwill, Written off Related to Sale of Business Unit   (121,717)  
Write-off of accum impairment loss related to sale of business unit   121,717  
Goodwill, Purchase Accounting Adjustments 560    
Translation adjustment (1,485) 811  
Apex
     
Goodwill [Roll Forward]      
Gross goodwill 288,502 289,712 289,712
Accumulated impairment loss 0 0 0
Goodwill 288,502 289,712 289,712
Translation adjustment (1,210) 0  
Oxford
     
Goodwill [Roll Forward]      
Gross goodwill 222,400 221,659 150,619
Accumulated impairment loss 0 0 0
Goodwill 222,400 221,659 150,619
Goodwill, Other Changes   513  
Translation adjustment (55) 0  
Physician
     
Goodwill [Roll Forward]      
Gross goodwill 58,777 59,013 51,561
Accumulated impairment loss 0 0 0
Goodwill 58,777 59,013 51,561
Translation adjustment 0 0  
Life Sciences Europe
     
Goodwill [Roll Forward]      
Gross goodwill 4,344 4,564 3,753
Accumulated impairment loss 0 0 0
Goodwill 4,344 4,564 3,753
Translation adjustment (220) 811  
Healthcare Segment
     
Goodwill [Roll Forward]      
Gross goodwill 0 0 122,230
Accumulated impairment loss 0 0 (121,717)
Goodwill 0 0 513
Goodwill, Written off Related to Sale of Business Unit   (121,717)  
Write-off of accum impairment loss related to sale of business unit   121,717  
Goodwill, Other Changes   (513)  
Translation adjustment 0 0  
CyberCoders [Member]
     
Goodwill [Roll Forward]      
Acquisition   70,527  
CyberCoders [Member] | Oxford
     
Goodwill [Roll Forward]      
Acquisition   70,527  
Goodwill, Purchase Accounting Adjustments 796    
Whitaker [Member]
     
Goodwill [Roll Forward]      
Acquisition   7,452  
Whitaker [Member] | Physician
     
Goodwill [Roll Forward]      
Acquisition   7,452  
Goodwill, Purchase Accounting Adjustments $ (236)