Cook tortellini according to package instructions. Drain and set aside.
In a large skillet, heat olive oil over medium heat. Add ground beef, salt, pepper, and Italian seasoning. Cook until browned, then drain excess grease.
Push beef to the side of the skillet and add butter and garlic. Sauté until fragrant.
Stir in cooked tortellini, fresh spinach, and heavy cream (if using). Let simmer for 2-3 minutes until spinach wilts.
Remove from heat and mix in Parmesan cheese.
Garnish with parsley and red pepper flakes (if using). Serve hot and enjoy!