There are different sets of competencies that are essential to the practice of healthcare management depending on the role. Although different studies list competencies for healthcare management, developing general and specific competencies has led to some debate about the theoretical body's applicability to the reality experienced by managers in the sector. This paper was developed based on a rapid review of the literature and iterative expert discussion, with the aim of aim of investigating the various conceptual perspectives and challenges surrounding the development of healthcare manager skills. As a result, we deepened the discussion on the different conceptualizations of competences and discussed the specificities aimed at health management. Discussing the competencies of a health manager requires defining what it is to be competent in the different contexts in which the manager operates. We address the particularities and similarities of different frameworks aimed at the health manager's competencies, as well as the different perspectives on what it is to be competent in each framework. We discussed the sector needs and pointed out some peculiarities of the Brazilian scenario, safeguarding unique aspects of this system and highlighting similarities and aspirations observed in other low- and middle-income countries.