The 40-year-old Keim -- who started with the franchise in 1999 as a college scout -- was named by club President Michael Bidwill to replace the fired Rod Graves.
Graves, along with head Coach Ken Whisenhunt, were released after the Cardinals stumbled to a 5-11 record and a last-place finish in the NFC West in 2012.
"I went through the process of evaluating the candidates and speaking with people both inside the facility and outside, I became more and more convinced Steve Keim was the right man to become general manager for the Arizona Cardinals," Bidwill said.
"I realize this is my home and I am a Cardinal at heart," Keim added. "I think we have some pieces in place, but the ability to run the ball consistently and the level of physicality, that's a huge issue and that needs to be fixed."
Keim played professionally briefly for the Miami Dolphins and Edmonton Eskimos.