01 - Boil a large pot of salted water. Cook pasta until al dente, reserving 1/2 cup of pasta water before draining and setting aside.
02 - In a small saucepan, combine cranberries, sugar, water, orange zest, and orange juice. Simmer over medium heat for 8-10 minutes until cranberries burst and sauce thickens. Set aside.
03 - Melt butter in a large skillet over medium heat. Add cream cheese and milk, whisking until smooth. Stir in Parmesan cheese, salt, and pepper.
04 - Add drained pasta to the skillet, tossing to coat. Gradually add reserved pasta water if needed to reach desired consistency.
05 - Gently swirl half of the cranberry sauce into the pasta and sauce mixture.
06 - Transfer to serving plates. Drizzle with remaining cranberry sauce and garnish with parsley and pecans, if using. Serve immediately.