½ cup grated pecorino romano, plus more for serving
Heat a large skillet over medium heat. Add enough olive oil to coat the bottom. Once the oil is hot, add the butternut squash. Allow to cook in an even layer until caramelized and tender, stirring often. Season with salt and black pepper. Transfer the squash to a plate and reserve.
Add a little more olive oil to the skillet. Break the sausage into pieces and add it in. Allow the sausage to brown on all sides, breaking it apart with a wooden spoon into smaller pieces as it cooks. Once browned and just cooked through, transfer the sausage to a plate and reserve.
Meanwhile, drop the orecchiette into a large pot of boiling, heavily-salted water. Cook for 1 minute less than the package’s instructions.
Add a little more olive oil to the skillet, along with the shallot. Cook for a minute or two until tender. Add the red chard and sage. Continue to cook as the greens wilt. Season well with salt.
Retrieve 1 cup of pasta water from the pot and add it to the greens. Drain the pasta and immediately add the pasta to the skillet. Stir well and add the squash and sausage back in to heat through as the liquid simmers. Stir in the cannellini beans and pecorino cheese. Continue to stir as the cheese melts.
Serve the orecchiette with a good drizzle of olive oil, lots of freshly cracked black pepper, and more grated pecorino over top.