01 - Bring a large pot of salted water to a boil. Cook pasta until al dente. Reserve 1/2 cup of pasta water, then drain and set 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 - In a large skillet over medium heat, melt butter. 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. Add reserved pasta water as needed to reach desired consistency.
05 - Gently swirl half of the cranberry sauce through the pasta.
06 - Transfer to serving plates. Drizzle with remaining cranberry sauce and garnish with parsley and pecans (if using). Serve immediately.