Turn sauté mode on Instant Pot and add in the oil and butter.
Add in the green pepper and onion, allowing to sauté about 3 minutes.
Add in the garlic and sausage, sautéing an additional 2-3 minutes.
Add in the paprika, Italian seasoning, broth, tomatoes, Cajun seasoning, Cayenne pepper, and uncooked pasta.
Stir a bit to push down the pasta into the liquid.
Turn off saute mode and place lid securely on top. Ensure valve is in sealing position.
Cook manual, high pressure, for 5 minutes followed by a quick release.
Once pin drops, open lid and stir in the cream cheese, Parmesan cheese, and heavy cream.
Once cheeses have melted and all has been incorporated, serve!