The professionalisation of health management has been pointed out as an urgent necessity for the qualification of work processes and the good performance of the health system in Brazil. In the state of Tocantins there has been an important investment with the creation of the position of Health Manager in the State Career Plan. With this in mind, this study aims to characterise the profile of the health manager at SESAU- TO, identifying the main activities performed and the challenges faced by these professionals. The data production process involved analysing documents and 93% of the managers recruited by the Health Department were interviewed. The findings show that 67% of the managers have between 3 and 6 years' experience. Most of the managers (27%) work in the area of Health Surveillance; 66% of these professionals dedicate themselves exclusively to the activities of the secretariat, without having any other employment relationship. The evidence shows that some managers don't use the basic SUS management tools, including: PPI, SIOPS and LDO, thus pointing to weaknesses in management, especially with regard to the public budget and decentralisation of resources.