Ivey was born Susan Hickok in Schenectady, New York. Her father was a manager with General Electric and her mother was a secretary and school volunteer. The family moved to Florida when she was two, and she graduated from Ft. Lauderdale High School in 1976. She earned a B.S. in business from the University of Florida in 1980 and an MBA from Bellarmine University in 1984.

Ivey's first job in the industry was as sales representative for Brown & Williamson in 1981. She was promoted to district sales manager in 1983, then moved to London in 1990 to serve as a brand director for Brown and Williamson's parent company, British American Tobacco. In 1994 she became Director of Marketing in China, based in Hong Kong, and moved back to England in 1996 to become Head of International Brands.

Ivey returned to the United States and to Brown & Williamson in 1999 to join the company's executive committee and serve as senior vice president of marketing.Ivey was named president of Brown & Williamson in January 2001.

In July 2004, Brown & Williamson combined with R. J. Reynolds, and Reynolds American, Inc. was created as a new holding company, with R. J. Reynolds Tobacco Company as its chief operating subsidiary. Ivey became president and CEO of the company in 2004. She became chairman in January 2006. She also served as chairman of R. J. Reynolds from July 2004 through April 2008.As head of Reynolds American, Ivey has guided the company's efforts into the smokeless tobacco category, including the introduction of products such as Camel snus and dissolvables.

In 2009, Forbes ranked Ivey as the 59th most powerful woman in the world.

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