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On 23 January 2018, after a brief spell working on the coaching staff at Portsmouth, Millen joined League One club Milton Keynes Dons as assistant manager.

On 22 April 2018, following the mutual contract termination of first team manager Dan Micciche, Millen was appointed caretaker manager of the club.

On 9 January 2017, subsequent to the appointment of Sam Allardyce as manager of Crystal Palace, it was announced that Millen had left the club. He has since been working with the Tottenham Hotspur development squad until he finds a new first team role.

Millen was appointed as Steve Coppell's successor, after Coppell chose to resign from Bristol City and retire from football. Millen spent most of his professional career at Brentford, where he reached the Associate Members' Cup final in 1985, and won the Football League Third Division in 1992. After leaving Brentford in 1994, he finished his playing career with Watford and Bristol City. Following retirement, Millen remained at City as a member of the coaching staff. He was caretaker manager at Ashton Gate following Gary Johnson's departure towards the end of the 2009–10 season. He took charge of nine competitive matches, winning five, drawing three and losing once. He was caretaker manager at Crystal Palace for 4 matches in the 2013–14 season winning one drawing one and losing 2. He was again appointed caretaker manager at Crystal Palace on 14 August 2014. On 27 August 2014 Neil Warnock was appointed full-time manager and at that time Millen's role at the club was not certain. However, on 12 September 2014 it was reported that Warnock was happy for Millen to continue in the role of assistant manager at Crystal Palace. Millen was re-appointed as caretaker manager on 27 December 2014 after Warnock was sacked following a poor run of results. On 2 January 2015, Alan Pardew was appointed to replace Warnock, and Millen reverted to assistant manager. On 9 January 2017, after Sam Allardyce was appointed as manager, Millen left Crystal Palace.

After Tony Pulis' surprise departure from Crystal Palace on 14 August 2014 (only 2 days before the start of the new Premier League season) Millen was again appointed caretaker manager. However, when Neil Warnock was appointed permanent Manager on 27 August 2014, Millen's future was not made clear. On 12 September 2014 it was reported that Neil Warnock was happy for Millen to continue as assistant manager at Crystal Palace.

On 27 December 2014, Millen took over as caretaker manager of Crystal Palace for a third time following Warnock being sacked. When Alan Pardew was appointed to replace Warnock on 2 January 2015 Millen reverted to assistant manager.

After a brief spell as Head of Coaching and Development at Blackpool earlier in the year, Millen was appointed Assistant Manager at Crystal Palace in November 2012, following former Blackpool manager Ian Holloway. On 23 October 2013, Millen was appointed as caretaker manager after Holloway left by mutual consent.

On 26 November 2013, newly appointed Crystal Palace manager Tony Pulis announced that Millen will be kept as backroom staff. This is likely because Millen had successfully restored team spirit back into the Crystal Palace squad and inspired Palace to 3 points closer to safety of relegation with 0–0 home draw to Everton, followed by a 1–0 away win over Hull City.

Following his retirement from football, Millen became under-17 manager at Bristol City. When Brian Tinnion was promoted to player-manager in 2004, he appointed Millen as his assistant. Under Tinnion's management City won 22 of 61 matches, and Millen was appointed as caretaker when Tinnion left the club. However, he publicly ruled himself out of the running to become the permanent manager. He was made caretaker manager of City when Gary Johnson left the club in March 2010, and became manager on a full-time basis on a three-year contract when Johnson's replacement, Steve Coppell, departed on 12 August 2010. Millen left the manager's position on 3 October 2011.

Millen joined Bristol City in November 1999. In the 2000 Auto Windscreens Shield final at Wembley, Millen captained Bristol City in a 2–1 defeat to Stoke City. He played his last competitive game in August 2002, a 2–0 home win over Blackpool before retiring in 2003, and later joining the club's coaching staff.

Millen joined Watford along with defensive partner Colin Foster in March 1994, helping them escape relegation that season. Although Watford were eventually relegated in 1996, Millen later played a part in the club achieving successive promotions under Graham Taylor between 1997 and 1999. In total, Millen made 165 appearances for Watford, scoring 5 goals.

He helped the club to the Football League Third Division title in 1991–92, and earned a testimonial match against Tottenham Hotspur in 1993 following ten years as a professional.

After spells as an apprentice at Southampton and Crystal Palace, Millen also spent time as a junior at Brentford, before turning professional in 1983. Between then and 1993 he made 305 League appearances for the club, scoring 17 goals. He helped Brentford reach the final of the Associate Members' Cup in 1985, where they were defeated 3–1 by Wigan Athletic at Wembley Stadium.

Keith Derek Millen (born 26 September 1966) is an English football manager and former player who played as a centre back. Millen was most recently the caretaker manager of League Two club Milton Keynes Dons. He was appointed manager of Swedish club Örgryte IS in December 2019.