Heat the olive oil over medium-high heat in a skillet. Add the sausage and saute until nice and brown and cooked through, breaking it up with a wooden spoon as you go. Drain the grease from the meat, remove it from the skillet, and set aside.
Cook the pasta following the package instructions, and then set aside.
In the same skillet you made the sausage in, whisk together the garlic, onion powder, Italian seasoning, milk, Rotel, cream cheese, cheddar, smoked paprika, salt, and pepper and cook over medium-low heat, stirring occasionally, until the cheese has melted. Some cheese brands are harder to melt, so if the sauce is too thick and the cheese becomes stringy, you can add a couple more tablespoons of milk help break it up and thin it out.
Stir the cooked pasta and cooked sausage into the sauce until everything is well incorporated.
Serve garnished with fresh parsley if desired.
Notes
I recommend full fat cream cheese for the best texture.