Heat butter and oil in a large skillet over medium heat. Stir in the onions and cook for a few minutes until tender. Add garlic and cook another minute.
Add ground turkey to the skillet and season with salt and pepper. Cook ground turkey, breaking it up with a spatula and stirring until browned and completely cooked through.
Before finishing the sauce, bring a large pot of water to a boil and cook cheese tortellini according to package instructions. Drain, and set aside.
Stir tomato paste into the meat mixture. Slowly pour in heavy cream while stirring frequently. Stir in parmesan cheese with basil, oregano, and parsley. Add 1 - 3 teaspoons of red pepper flakes depending on the spice level you want.
Gently toss cooked tortellini into the meat sauce. Enjoy!