Bring a large pot of salted water to a boil and cook rigatoni until al dente. Reserve ½ cup pasta water and drain.
In a bowl, combine ground beef, egg, breadcrumbs, garlic, parmesan, Italian seasoning, salt, and pepper. Form into small meatballs.
Heat a skillet over medium heat and cook meatballs for 8–10 minutes, turning until browned and cooked through to 160°F (71°C).
Remove meatballs and set aside.
In the same skillet, add olive oil and garlic. Cook for 30 seconds until fragrant.
Stir in tomato sauce, cream, parmesan, Italian seasoning, and paprika. Simmer for 4–5 minutes.
Add cooked rigatoni and a splash of reserved pasta water. Toss until coated.
Return meatballs to the skillet and gently mix.
Garnish with parsley and extra parmesan before serving.

Notes:

Ground turkey or chicken can replace beef.
Add red pepper flakes for a little heat.
Leftovers keep well refrigerated for up to 3 days.
Serve with garlic bread and a simple green salad.