Crisp the chopped bacon in a wide skillet over medium heat. Transfer to a plate and reserve 2 tablespoons drippings.
Brown the ground beef in the bacon fat, breaking it up as it cooks. Spoon off excess grease if needed.
Stir in onion and cook until softened, about 3 minutes. Add garlic and cook 30 seconds until fragrant.
Mix in tomato paste and cook 1 minute to toast. Stir in ketchup, mustard, Worcestershire, paprika, salt, and pepper.
Pour in beef broth and milk. Bring to a lively simmer.
Stir in the dry macaroni. Reduce heat, cover, and simmer, stirring occasionally, until pasta is just tender, 10–12 minutes.
Lower heat. Blend in the cream cheese until smooth and creamy.
Fold in half the cheddar, most of the bacon, and most of the pickles. Stir until the cheese melts.
Scatter the remaining cheddar on top. Cover 1–2 minutes to melt. Garnish with reserved bacon, pickles, and green onions.