Remove the steak from the refrigerator and let it sit at room temperature for 20-30 minutes. Pat completely dry with paper towels and season generously on both sides with salt, pepper, garlic powder, and paprika.

Bring a large pot of salted water to a rolling boil. Add the tortellini and cook according to package directions until al dente, usually 3-5 minutes for fresh or 7-9 minutes for frozen. Drain and set aside, reserving 1 cup of pasta water.

While the pasta cooks, heat olive oil in a large cast-iron skillet or heavy-bottomed pan over high heat until it begins to shimmer and smoke slightly.

Carefully place the steak in the hot pan and sear without moving for 4-5 minutes until a deep brown crust forms. Flip and cook for another 4-5 minutes for medium-rare, or adjust time according to your preferred doneness.

Remove the steak from the pan and let it rest on a cutting board for 10 minutes. This allows the juices to redistribute throughout the meat.

In the same pan (wiped clean if needed), reduce heat to medium and melt the butter. Add minced garlic and sauté for 30 seconds until fragrant but not browned.

Pour in the heavy cream and bring to a gentle simmer. Let it bubble gently for 3-4 minutes, stirring occasionally, until it begins to thicken slightly.

Reduce heat to low and gradually whisk in the Parmesan cheese, stirring constantly until the cheese melts completely and the sauce becomes smooth and creamy. Season with salt, pepper, and nutmeg if using.

Add the cooked tortellini to the alfredo sauce and toss gently to coat each piece evenly. If the sauce seems too thick, add reserved pasta water one tablespoon at a time until you reach desired consistency.

Slice the rested steak against the grain into thin strips. Arrange the creamy tortellini on plates or in a serving bowl and top with the sliced steak.

Garnish with freshly cracked black pepper, additional Parmesan cheese, and chopped fresh parsley. Serve immediately while hot.