The 50-year-old, who signs a deal until the end of the 2017/18 campaign, beat off competition from over 50 candidates to land the role and become Steve Evans' successor at the AESSEAL New York Stadium.
Redfearn made it through a vigorous selection process, including two interviews, with Hibs manager Alan Stubbs believed to have been pipped to the post.
A club statement read: "Rotherham United are delighted to announce the appointment of Neil Redfearn as the club’s first team manager.
Redfearn has been out of work since leaving Leeds in the summer after a tumultuous spell.
The Yorkshireman had three spells in caretaker charge of the Elland Road club while academy manager before eventually getting the job on a permanent basis last October.
Despite chaos off the field under the stewardship of Italian Massimo Cellino, he led Leeds away from relegation in the Championship and to mid-table safety.
However, that was not enough for him to keep his job and, despite being allowed to return to his previous role with the academy when Uwe Rosler was appointed, he found the position untenable and left in July.
Redfearn is credited with developing young talent while at Leeds, with Alex Mowatt, Lewis Cook and Sam Byram all coming through the ranks, and that is a skill that impressed Millers chairman Tony Stewart.