Cook rigatoni in a large pot of salted water according to package instructions. Drain and set aside.
In a large skillet, heat olive oil over medium heat. Add onion and sauté until soft, about 3-4 minutes.
Add garlic and cook for another minute until fragrant.
Add the Italian sausage to the skillet, breaking it apart as it cooks. Cook until browned and no longer pink.
Stir in red pepper flakes, paprika, Italian seasoning, salt, and pepper. Cook for 1 minute to toast the spices.
Pour in crushed tomatoes and heavy cream. Stir to combine and bring to a simmer.
Add Parmesan cheese and stir until melted and sauce thickens slightly.
Toss in the cooked rigatoni and mix until evenly coated in the sauce.
Garnish with fresh parsley and extra Parmesan before serving.