Heat olive oil in a large skillet over medium-high heat and brown the sausage slices.
Add the red onion and bell peppers to the skillet and sauté until softened, about 5 minutes.
Stir in the minced garlic and cook for 1 minute until fragrant.
Add the dry pasta, fire-roasted tomatoes, water, Cajun seasoning, and smoked paprika to the skillet.
Bring the mixture to a boil, then reduce heat to a simmer, covering the skillet to cook for 10-12 minutes or until pasta is al dente.
In a separate small saucepan, melt the butter and whisk in the flour to create a roux, then gradually whisk in the milk until thickened.
Stir in the cream cheese and Parmesan cheese into the sauce mixture until smooth.
Pour the creamy sauce into the pasta skillet and toss to combine thoroughly.
Garnish with fresh parsley and serve hot.