01 - In a large soup pot or Dutch oven, heat olive oil over medium heat. Add sausage with casings removed and cook, breaking it apart with a wooden spoon, until evenly browned. Transfer sausage to a plate using a slotted spoon, leaving the rendered fat in the pot.
02 - Add diced onion, sliced carrots, and sliced celery to the pot. Cook for 5 minutes, stirring occasionally, until vegetables are softened. Add minced garlic and cook for 1 minute until fragrant.
03 - Stir in the cubed butternut squash, dried thyme, ground nutmeg, and half of the chopped fresh sage. Season generously with salt and pepper. Sauté for 2 to 3 minutes to coat the squash in the seasonings.
04 - Pour in the chicken broth and bring to a boil. Reduce heat to a simmer, cover the pot, and cook for 20 minutes until the butternut squash is fork-tender.
05 - Use an immersion blender to partially or fully purée the soup for a creamy texture. Leave some chunks intact for a heartier consistency, or blend fully for a silky smooth base.
06 - Return the browned sausage to the pot. Stir in the cheese tortellini and simmer uncovered for 6 to 8 minutes until the tortellini are cooked through and tender.
07 - Pour in the heavy cream and add the remaining chopped fresh sage. Heat gently without boiling, then taste and adjust seasoning with salt and pepper as needed. Remove from heat.
08 - In a small bowl, combine softened cream cheese, ricotta cheese, finely chopped fresh sage, milk, and a pinch of salt and pepper. Blend until completely smooth and creamy.
09 - Ladle the hot soup into serving bowls. Add a generous spoonful of the sage cheese swirl to each bowl and gently swirl it into the surface with a spoon or knife. Garnish with extra fresh sage or cracked black pepper and serve immediately.